Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TR0400X | Rehabilitation Psychologist | FL |
NPI | 1477918373 |
---|---|
Provider Name | Ciara Mccoy |
First Address | Deerfield Beach, FL 33441-1817 |
Second Address | Deerfield Beach, FL 33441-1817 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2015 |
Last Update Date | 15/06/2016 |