| NPI | 1720356512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIFRANCES CHRISTINE GULLO Owner 386-310-8766 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: FL ARNP2530742) |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2019-12-09 |