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General NPI Number Information
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NPI Number | 1972792745
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Entity Type | Organization
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Legal Business Name | PSYCH ALLIANCE INC
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Dates
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Enumeration Date | 10/17/2007
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 9360 SUNSET DR SUITE 234
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City | MIAMI
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State | FL
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Zip | 33173-5432
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Country | US
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Telephone | 305-274-9755
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Fax | 305-274-4137
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Provider Business Mailing Address
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Address Line | 9360 SUNSET DR SUITE 234
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City | MIAMI
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State | FL
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Zip | 33173-5432
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Country | US
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Telephone | 305-274-9755
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Fax | 305-274-4137
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Authorized Official
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Title or Position | PSTD
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Name | DR. IVAN F DANGER
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Credential |
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Telephone | 305-274-9755
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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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