| NPI | 1487015491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGIE MOLINET MOLINA Operating Manager 305-669-2549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY7041) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL PY7041) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY7041) | |
| Enumeration Date | 2016-03-18 |
| Last Update Date | 2021-05-19 |