| NPI | 1740450709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATY PURCELL Administrator 772-465-3613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY2546) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2008-03-06 |