| NPI | 1750826285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE AVERY-CLARK Owner 954-849-7997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY3980) |
| Enumeration Date | 2016-12-19 |
| Last Update Date | 2016-12-19 |