| NPI | 1003205741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN JAMES WEIS Chairman 954-260-0361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA Psy003142) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: GA Psy003141) |
| Enumeration Date | 2015-01-19 |
| Last Update Date | 2015-01-22 |