| NPI | 1003424730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN COLANTUNO Admin 954-803-9002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-20 |