| NPI | 1811308901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE WACHTEL Psychologist 904-834-2235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL P40005827) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2016-07-22 |