| NPI | 1801103866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROXANNE LOUH Psychologist 904-318-9418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7400) |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2019-05-07 |