Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | PY 2924 | FL |
NPI | 1093950750 |
---|---|
Provider Name | Dr. Cary Shookoff |
First Address | Miami Beach, FL 33139-1400 |
Second Address | Miami Beach, FL 33139-1400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2008 |
Last Update Date | 16/08/2019 |