Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY5138 | FL |
Y | 103TC0700X | Clinical Psychologist | PY5138 | FL |
NPI | 1013062322 |
---|---|
Provider Name | Dr. Annette Blanchard Massey |
First Address | Davie, FL 33331-1515 |
Second Address | Pembroke Pines, FL 33026-3200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 25/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R79106 | (02) | FL |