| NPI | 1639842248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDEY CLARKE LANDKROHN Director 904-244-3603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2021-07-29 |