| NPI | 1104450642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ELIZABETH MOE PT/ Licensed Clinical Psychologist 561-331-2302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2020-05-16 |