| NPI | 1750726147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA MAKI Psychologist 850-933-7042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL PY-7527) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2013-04-30 |