NPI | 1669825220 |
---|---|
Entity Type | Organization |
Authorized Contact | JERRY LEWIS TAYLOR CEO/Owner 386-212-2061 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Additional Taxonomies | 363L00000X Nurse Practitioner |
Enumeration Date | 2016-07-19 |
Last Update Date | 2016-07-19 |