| NPI | 1902801210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L TALLMAN President 850-729-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY4285) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY5264) |
| 103T00000X Psychologist (Licence: FL PY4031) | |
| 103T00000X Psychologist (Licence: FL PY7250) | |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2008-04-20 |