| NPI | 1871509687 |
|---|---|
| Other Name | LLC SOLE MEMBER |
| Entity Type | Organization |
| Authorized Contact | JOANN STEPHENS Executive Director 305-558-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY6483) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL Py6483) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-08-22 |