| NPI | 1730532284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOGAN PERSONS JONES Owner 813-389-1788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 021566) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2024-01-30 |