| NPI | 1801207345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD G. RICKNER Psychologist 850-668-0482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY0005144) |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2014-05-19 |