| NPI | 1821588625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH WALDEN Psychologist 321-253-8887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY10130) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2021-10-07 |