| NPI | 1619119690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHRYN E VAN BRACKLE Psychologist 305-331-2553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY7396) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2009-07-16 |