Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PY6660 | FL |
N | 103T00000X | Psychologist | PY6660 | FL |
N | 103G00000X | Clinical Psychologist | PY6660 | FL |
N | 103TC0700X | Clinical Psychologist | PY6660 | FL |
N | 103TC1900X | Counseling Psychologist | PY6660 | FL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PY6660 | FL |
NPI | 1033107537 |
---|---|
Provider Name | Adam Feder |
First Address | Miami, FL 33175 |
Second Address | Coral Springs, FL 33067 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2005 |
Last Update Date | 08/07/2007 |