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General NPI Number Information
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NPI Number | 1689122160
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Entity Type | Individual
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Provider Name | BRIAN R. BECRAFT PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 450 N PARK RD STE 400
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6918
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Country | US
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Telephone | 954-925-3191
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Fax |
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Provider Business Mailing Address
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Address Line | 16632 NW 23RD ST APT. 14-104
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1890
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Country | US
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Telephone | 954-616-7804
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PY 9662
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License Number State | FL
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