| NPI | 1649324005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN M CROUGHN Office Manager 407-740-6838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY3963) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |