| NPI | 1902449689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA SHALENE DIXON Clinical Psychologist 941-479-7866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-10-24 |
| Last Update Date | 2019-10-24 |