| NPI | 1821213323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNNE PARKER GALLEGO Administrator 941-764-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: FL MH0004146) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME0076119) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |