| NPI | 1770999229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY WAYNE THOMPSON President/CEO 941-685-7228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY580700) |
| Enumeration Date | 2014-07-05 |
| Last Update Date | 2014-07-05 |