| NPI | 1740788538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANISA SOPHIA MOHAMMED Psychologist 813-401-7624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 5667) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2018-01-26 |