| Bill Bracker, Psyd, Llc | |
|
1881 Ne 26th St Wilton Manors FL 33305-1416 | |
| (954) 895-1022 | |
| Not Available |
| Full Name | Bill Bracker, Psyd, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1881 Ne 26th St, Wilton Manors, Florida |
| Authorized Official Name and Position | William Bracker (OWNER/MEMBER) |
| Authorized Official Contact | 9548951922 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bill Bracker, Psyd, Llc Po Box 4722 Fort Lauderdale FL 33338-4722 Ph: (954) 895-1022 | Bill Bracker, Psyd, Llc 1881 Ne 26th St Wilton Manors FL 33305-1416 Ph: (954) 895-1022 |
| NPI Number | 1184186553 |
|---|---|
| Provider Enumeration Date | 04/03/2019 |
| Last Update Date | 02/04/2023 |
| Certification Date | 02/04/2023 |
| Medicare PECOS PAC ID | 0547591745 |
|---|---|
| Medicare Enrollment ID | O20191018000671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184186553 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | William Bracker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407882145 PECOS PAC ID: 4688725906 Enrollment ID: I20090626000413 |
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