| NPI | 1770041071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RAILEY Psychologist 850-508-5285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2024-06-26 |