| NPI | 1265765242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI LENAY EICKLEBERRY Licensed Psychologist 954-315-1774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7732) |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2023-11-06 |