| NPI | 1831123173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN P. DAVIS President 772-398-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY 5785) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-08-22 |