| NPI | 1770838872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIENNE LEIGH DESANTIS KING Managing Member/Owner/Psychologist 904-419-7792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2018-06-16 |