Basic Information
| Provider Information | |||||||||
| NPI: | 1982792438 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | D&D PSYCH INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7392 NW 35TH TER | ||||||||
| Address2: | SUITES 201/202 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331221271 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055979494 | ||||||||
| FaxNumber: | 3055979495 | ||||||||
| Practice Location | |||||||||
| Address1: | 7392 NW 35TH TER | ||||||||
| Address2: | SUITES 201/202 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331221271 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055979494 | ||||||||
| FaxNumber: | 3055979495 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/10/2006 | ||||||||
| LastUpdateDate: | 10/24/2007 | ||||||||
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| AuthorizedOfficialLastName: | RAURELL | ||||||||
| AuthorizedOfficialFirstName: | GABRIELA | ||||||||
| AuthorizedOfficialMiddleName: | MARIA | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7862712651 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | LMHC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | HCC5392 | FL | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.