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General NPI Number Information
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NPI Number | 1093835761
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Entity Type | Individual
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Provider Name | MICHELLE RENEE HINTZ PSYD, MT-BC
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 05/27/2014
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Provider Practice Location Address
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Address Line | 450 N PARK RD SUITE 400
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6917
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Country | US
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Telephone | 954-925-3191
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Fax | 954-925-3193
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Provider Business Mailing Address
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Address Line | 450 N PARK RD SUITE 400
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6917
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Country | US
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Telephone | 954-925-3191
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Fax | 954-925-3193
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PY7496
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License Number State | FL
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