| NPI | 1992114276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN P PHILLIPS Psychologist 813-997-4538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: FL PY7291) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2015-03-03 |