| NPI | 1780971671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN CRAVEN WILLIAMS Psychologist 904-716-0757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL py5815) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2023-01-14 |