| NPI | 1770715922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY ANDERSON Administrator 407-539-1935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL 4336PSY) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 2791) |
| 103T00000X Psychologist (Licence: FL PY 7320) | |
| 1041C0700X Social Worker, Clinical (Licence: FL SW 6782) | |
| 106H00000X Marriage & Family Therapist (Licence: FL MT 1709) | |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2009-08-20 |