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General NPI Number Information
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NPI Number | 1558532564
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Entity Type | Organization
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Legal Business Name | AMIN PSYCHOLOGICAL HEALING AND LIFE ENHANCEMENT
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 300 S. PINE ISLAND RD. SUITE # 211
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City | PLANTATION
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State | FL
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Zip | 33324-2620
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Country | US
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Telephone | 954-732-1103
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Fax | 954-474-5851
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Provider Business Mailing Address
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Address Line | 1431 N.W. 105 AVE.
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City | PLANTATION
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State | FL
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Zip | 33322-6602
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Country | US
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Telephone | 954-732-1103
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Fax | 954-474-5851
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. MONA AMIN KALHOR
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Credential | PSY-D
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Telephone | 954-732-1103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | PY 6582
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License Number State | FL
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