| NPI | 1972939767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED JOSEPH RAHAIM Licensed Psychologist 904-704-0851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY00002524) |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2013-09-24 |