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3526 S University Dr Davie FL 33328-2002 | |
| (954) 262-5730 | |
| (954) 262-3855 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3526 S University Dr, Davie, Florida |
| Authorized Official Name and Position | Robert S. Oller (CEO/DIVISION OF CLINICAL OPERATIONS) |
| Authorized Official Contact | 9542624399 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 290250 Davie FL 33329-0250 Ph: (954) 262-4334 | 3526 S University Dr Davie FL 33328-2002 Ph: (954) 262-5730 |
| NPI Number | 1366790552 |
|---|---|
| Provider Enumeration Date | 08/21/2012 |
| Last Update Date | 08/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366790552 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 103TB0200X | Psychologist - Cognitive & Behavioral | (* (Not Available)) | Secondary |
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