| NPI | 1104298934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA C BRINSON Owner 954-257-7473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: FL SS914) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL SS914) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2021-06-21 |