| NPI | 1740497643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN JOSEPH LARRABEE Owner 941-955-9596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY 3543) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY3543) |
| 103TF0200X Psychologist, Forensic (Licence: FL PY 3543) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2008-02-29 |