| NPI | 1760708754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUMMER L SULLIVAN Member 305-662-2686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY 5818) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: FL PY 7923) |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2010-04-15 |