| NPI | 1851706097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA DM GRANT Director Member 786-269-7819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9903) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2014-06-26 |