| NPI | 1336421718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA DICICCO REYNOLDS Psychologist/Owner 954-787-9711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY 7384) |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2021-05-06 |