| NPI | 1881134179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MADY Clinical Psychologist 321-802-3430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL 8977) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |