| NPI | 1063750347 |
|---|---|
| Former Legal Business Name | FORT LAUDERDALE PSYCHOLOGY PA |
| Entity Type | Organization |
| Authorized Contact | NICOLLE A. DELEO Owner/President 954-260-8790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL 8799) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 10032) |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2017-03-24 |