| NPI | 1225544232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULENE HAZEL Owner 954-292-4088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL 0-03-0807) |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2024-10-23 |