| NPI | 1477719060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROE F CLARKE Psychologist 954-588-7107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY4970) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: FL PY4970) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: FL PY4970) | |
| 103TF0000X Psychologist, Family (Licence: FL PY4970) | |
| 103TH0004X Psychologist, Health (Licence: FL PY4970) | |
| Enumeration Date | 2008-08-02 |
| Last Update Date | 2013-05-16 |