| NPI | 1669716247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE FLORES Accounts Specialist 754-201-2265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY8127) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL PY8127) |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2012-11-20 |