| NPI | 1104190180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA E SHAKES MALONE Owner 954-583-4568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY7376) |
| Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: FL py7376) |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2012-03-08 |