| NPI | 1902037013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA LUTZ School Psychologist 866-960-8806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH8518) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: FL SS795) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |