| NPI | 1750582466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA ANN BURCH Administrator 727-584-1551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2009-12-07 |