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General NPI Number Information
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NPI Number | 1023289212
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Entity Type | Organization
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Legal Business Name | WUNDERMAN & WUNDERMAN, P.A.
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Dates
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Enumeration Date | 03/17/2008
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 8600 SW 92ND ST SUITE 203
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City | MIAMI
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State | FL
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Zip | 33156-7397
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Country | US
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Telephone | 305-595-6633
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Fax | 305-385-7164
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Provider Business Mailing Address
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Address Line | 8600 SW 92ND ST SUITE 203
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City | MIAMI
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State | FL
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Zip | 33156-7397
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Country | US
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Telephone | 305-595-6633
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Fax | 305-385-7164
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. TERILEE WUNDERMAN
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Credential | PH.D.
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Telephone | 305-595-6633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PY4278
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License Number State | FL
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