| NPI | 1710075916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE ELIZABETH SIDBERRY President 954-382-4889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY 6164) |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2008-10-15 |