| NPI | 1720540214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY PELEGRIN Administrator 305-627-5557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 2084A0401X Psychiatry & Neurology Addiction Medicine | |
| 208D00000X General Practice | |
| Enumeration Date | 2019-04-03 |
| Last Update Date | 2020-03-11 |