| NPI | 1922523497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER ANTHONY WILCOX Lcsw Consultant 352-208-0284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: FL 14000) |
| 122300000X Dentist | |
| 1223S0112X Dentist Oral and Maxillofacial Surgery | |
| 207N00000X Dermatology | |
| 2084N0400X Psychiatry & Neurology Neurology | |
| Enumeration Date | 2017-08-07 |
| Last Update Date | 2023-04-14 |