| NPI | 1801154877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEELY WATERS KAKLAMANOS Licensed Psychologist, Manager 850-528-8895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7401) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY4135) |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2012-04-27 |