| NPI | 1790068344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA SHALENE DIXON Clinical Psychologist 727-322-6123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL PY8356) |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2011-09-21 |