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General NPI Number Information
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NPI Number | 1205143765
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Entity Type | Organization
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Legal Business Name | PAICA-N PSYCHOLOGICAL ASSESSMENT AND INTERVENTIONS FOR CHILDREN
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Dates
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Enumeration Date | 09/06/2010
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Last Update Date | 09/06/2010
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Provider Practice Location Address
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Address Line | 2645 EXECUTIVE PARK DR 504
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City | WESTON
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State | FL
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Zip | 33331-3624
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Country | US
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Telephone | 954-641-3458
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Fax | 954-385-3303
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Provider Business Mailing Address
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Address Line | 2645 EXECUTIVE PARK DR 504
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City | WESTON
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State | FL
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Zip | 33331-3624
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Country | US
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Telephone | 954-641-3458
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Fax | 954-385-3303
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. NORDA HERNANDEZ
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Credential | PSY.D.
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Telephone | 954-641-3458
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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 | PY7910
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License Number State | FL
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