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General NPI Number Information
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NPI Number | 1013062322
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Entity Type | Individual
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Provider Name | ANNETTE BLANCHARD MASSEY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 11/25/2009
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Provider Practice Location Address
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Address Line | 1601 N PALM AVE SUITE 300
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City | PEMBROKE PINES
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State | FL
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Zip | 33026-3200
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Country | US
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Telephone | 954-536-9032
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Fax |
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Provider Business Mailing Address
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Address Line | 2780 SW 155TH LN
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City | DAVIE
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State | FL
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Zip | 33331-1515
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Country | US
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Telephone | 954-536-9032
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY5138
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 222Q00000X
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Taxonomy Name | Developmental Therapist
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License Number |
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License Number State |
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