| NPI | 1639699754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL S WACHOWIAK Owner, Psychologist 305-978-3670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0004X Psychologist Health (Licence: TX 35130) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health (Licence: TX 35130) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2018-03-17 |