Organization Name: | WHOLE AGAIN INSTUTE FOR WELLNESS, INC |
NPI Number: | 1447519418 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JESSICA E RIVERA (PRESIDENT, CEO) |
Mailing Address: | 12781 Miramar Parkway Suite 1-105 Miramar |
State: | FL US |
Postal Code: | 33027 |
Phone Number: | 9549338299 |
Fax Number: | 7863450776 |
NPI Enumeration Date: | 05/11/2012 |
NPI Last Update Date: | 05/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |