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General NPI Number Information
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NPI Number | 1588867303
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL INSTITUTE FOR WELLNESS AND EMPOWERMENT
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Dates
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Enumeration Date | 06/08/2007
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Last Update Date | 01/17/2008
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Provider Practice Location Address
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Address Line | 941 NE 19TH AVE SUITE 308
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-3092
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Country | US
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Telephone | 954-937-0241
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Fax | 954-522-6508
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Provider Business Mailing Address
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Address Line | 941 NE 19TH AVE SUITE 308
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City | FORT LAUDERDALE
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State | FL
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Zip | 33304-3092
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Country | US
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Telephone | 954-937-0241
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Fax | 954-522-6508
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | DR. EDUARDO MAGALHAES
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Credential | PH.D.
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Telephone | 954-937-0241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 7639
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License Number State | FL
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