| NPI | 1790024321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN SULLIVAN President/Director 772-349-1871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL P12000055618) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2013-02-01 |