| NPI | 1770967309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED KHAN Licensed Psychologist 352-804-1846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY8523) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2015-07-14 |