| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 6521 Orange Dr, Davie, Florida |
| Authorized Official Name and Position | Mary-debra Pawlowski (PRESIDENT) |
| Authorized Official Contact | 9545584334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2048 Sw 175th Ave Miramar FL 33029-5526 Ph: (954) 558-4334 | 6521 Orange Dr Davie FL 33314-3340 Ph: (954) 417-7005 |
| NPI Number | 1306104302 |
|---|---|
| Provider Enumeration Date | 04/26/2012 |
| Last Update Date | 05/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306104302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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