| NPI | 1710243571 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | GINGER HUDNALL Office Administrator 904-527-8777 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME108768) | 
| Enumeration Date | 2012-04-05 | 
| Last Update Date | 2025-01-31 |