| NPI | 1962435271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE R DEMENKOW Owner 954-856-8703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP9211884) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY6763) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-05-20 |