| NPI | 1992104111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE ABBY KOCH Owner/Psychologist 813-399-1625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY4230) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2014-08-14 |