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General NPI Number Information
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NPI Number | 1902732209
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Entity Type | Organization
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Legal Business Name | WILLIAMSBURG THERAPY GROUP MIAMI LLC
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Dates
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Enumeration Date | 06/23/2026
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Last Update Date | 06/23/2026
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Provider Practice Location Address
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Address Line | 3390 MARY ST STE 116
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City | COCONUT GROVE
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State | FL
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Zip | 33133-5255
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Country | US
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Telephone | 305-363-1221
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Fax |
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Provider Business Mailing Address
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Address Line | 10 OAKWOOD DR
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City | LLOYD HARBOR
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State | NY
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Zip | 11743-9748
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Country | US
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Telephone | 718-757-7033
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | DANIEL SELLING
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Credential | PSYD
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Telephone | 718-757-7033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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