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General NPI Number Information
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NPI Number | 1518312420
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Entity Type | Organization
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Legal Business Name | T4 CONSULTING INC
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Dates
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Enumeration Date | 04/28/2016
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 247 SW 7TH ST
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City | POMPANO BEACH
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State | FL
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Zip | 33060-8395
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Country | US
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Telephone | 773-896-8994
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Fax |
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Provider Business Mailing Address
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Address Line | 247 SW 7TH ST
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City | POMPANO BEACH
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State | FL
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Zip | 33060-8395
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Country | US
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Telephone | 773-896-8994
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRAVIS M THOMPSON
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Credential |
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Telephone | 773-879-8272
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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 | PY8628
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License Number State | FL
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