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General NPI Number Information
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NPI Number | 1396005658
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Entity Type | Organization
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Legal Business Name | D&D PSYCH
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Dates
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Enumeration Date | 05/21/2012
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Last Update Date | 05/21/2012
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Provider Practice Location Address
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Address Line | 7392 NW 35TH TER
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City | MIAMI
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State | FL
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Zip | 33122-1271
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Country | US
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Telephone | 305-597-9494
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Fax |
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Provider Business Mailing Address
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Address Line | 8126 LAKEPOINTE DR
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City | PLANTATION
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State | FL
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Zip | 33322-5741
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Country | US
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Telephone | 919-624-4236
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | FABIENNE PIERRE
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Credential | MSW
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Telephone | 919-624-4236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | ISW 3358
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License Number State | FL
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