| Organization Name: | VISTA PSYCHOLOGICAL SERVICES, PA |
| NPI Number: | 1013073980 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CATHERINE W GIBSON (V PRES) |
| Mailing Address: | 120 University Park Dr Suite 215 Winter Park |
| State: | FL US |
| Postal Code: | 327924440 |
| Phone Number: | 4076575800 |
| Fax Number: | 4076574269 |
| NPI Enumeration Date: | 12/28/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH3101 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |