| NPI | 1730729823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NUSIRAT DAODU CEO 407-505-9704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0100X Psychologist Health Service |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 101YS0200X Counselor School | |
| 102L00000X Psychoanalyst | |
| 103G00000X Clinical Neuropsychologist | |
| 103K00000X Behavior Analyst | |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist Clinical | |
| 103TC1900X Psychologist Counseling | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TP2701X Psychologist Group Psychotherapy | |
| 103TS0200X Psychologist School | |
| 251E00000X Home Health | |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2024-01-08 |