| NPI | 1265834980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNIE SHAYNA BROOKS Officer/Director 954-854-6145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7961) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: FL PY7961) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2014-09-24 |