| NPI | 1881891174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE MARIE BILLIOT President 386-672-9250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7252) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2009-01-16 |