| NPI | 1700214459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE G WILLIAMS Clinical Director 772-223-9988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY5917) |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2016-10-10 |