| NPI | 1790198463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICKAELLA MORETA President 941-351-2221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PPY185) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2014-12-30 |