| NPI | 1740936319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROCIO RADA Owner 941-716-9951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 225XM0800X Occupational Therapist, Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2022-02-23 |
| Last Update Date | 2022-02-24 |