| NPI | 1902158314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN F ISOM Licensed Pschologist 305-652-1081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: FL PY3916) |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2012-10-09 |