| NPI | 1689164790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA CANTO Owner/Authorized Representative 850-296-3665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY10048) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: FL SS1033) |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2019-12-28 |