NPI | 1811457096 |
---|---|
Entity Type | Organization |
Authorized Contact | ALINA M CLAVIJO Authorized Official/Registered Agent 954-374-3636 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical |
Additional Taxonomies | 103T00000X Psychologist |
103TB0200X Psychologist, Cognitive & Behavioral | |
103TC1900X Psychologist, Counseling | |
Enumeration Date | 2019-03-22 |
Last Update Date | 2019-05-07 |