Basic Information
| Provider Information | |||||||||
| NPI: | 1396005658 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | D&D PSYCH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8126 LAKEPOINTE DR | ||||||||
| Address2: | |||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333225741 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196244236 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7392 NW 35TH TER | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331221271 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055979494 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2012 | ||||||||
| LastUpdateDate: | 05/21/2012 | ||||||||
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| AuthorizedOfficialLastName: | PIERRE | ||||||||
| AuthorizedOfficialFirstName: | FABIENNE | ||||||||
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| AuthorizedOfficialTitleorPosition: | MENTAL HEALTH THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 9196244236 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | ISW 3358 | FL | Y | Agencies | Community/Behavioral Health |
No ID Information.