| NPI | 1952629933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE RENEE CHANNING President / Owner 954-385-6750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY6745) |
| Enumeration Date | 2010-05-14 |
| Last Update Date | 2021-09-16 |