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General NPI Number Information
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NPI Number | 1811324189
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Entity Type | Organization
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Legal Business Name | BUILDING BLOCKS THERAPY 18 INC
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Dates
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Enumeration Date | 10/02/2013
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 960 W 41ST ST SUITE 116
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3326
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Country | US
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Telephone | 347-693-4975
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Fax |
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Provider Business Mailing Address
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Address Line | 960 W 41ST ST SUITE 116
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City | MIAMI BEACH
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State | FL
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Zip | 33140-3326
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. JONATHAN DOBKOWSKI
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Credential | PSY.D.
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Telephone | 347-693-4975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PY 8477
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License Number State | FL
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