| NPI | 1790181725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANY WEAVER President 727-244-1379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY6244) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: FL SW8645) |
| Enumeration Date | 2014-11-19 |
| Last Update Date | 2014-11-19 |