| NPI | 1699815753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNIE CROUGHN Office Manager 407-740-6838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL MH1651) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |