| NPI | 1649620972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HENDRICKSON Psychologist 786-247-5575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY3581) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2016-06-17 |