| NPI | 1801125869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN G. ELLIS President 727-536-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY2173) |
| Enumeration Date | 2009-12-21 |
| Last Update Date | 2009-12-21 |