| NPI | 1467639898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODIE K MOOREHEAD Owner 954-444-1445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: FL PY4324) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2008-01-29 |