| NPI | 1992388805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI LEYVA Credentialing And Compliance Office 954-431-9838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2021-04-29 |