| NPI | 1154943629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNE MICHELE SAMUELS Owner 786-246-7121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2020-05-07 |