| Provider Type: | Behavioral Health & Social Service Providers |
| Provider Classification: | Psychologist |
| Provider Specialization: | Rehabilitation |
| Address: |
11019 N Dale Mabry Hwy Tampa, FL 33618-3801 |
| Phone: | (813) 265-9262 |
| Fax: | (813) 265-4226 |
| Gender: | Male |
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