| NPI | 1912241571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK T SANDVOSS Psychotherapist 954-362-3590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW 7743) |
| Enumeration Date | 2012-11-20 |
| Last Update Date | 2012-11-20 |