| NPI | 1922200278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTY HELLER Office Manager 321-751-1925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY2592) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH5001) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH3865) | |
| 103G00000X Clinical Neuropsychologist (Licence: FL PY7627) | |
| 103TC0700X Psychologist, Clinical (Licence: FL PY4859) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME79036) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2012-03-07 |