| NPI | 1811457096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALINA M CLAVIJO Authorized Official/Registeredagent 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 |