| NPI | 1982978193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUY L TEWKSBURY President 727-375-5924 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY4179) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-06 |