Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY4064 | FL |
Y | 103TC0700X | Clinical Psychologist | PY4064 | FL |
N | 102L00000X | Psychologist | PY4064 | FL |
N | 103T00000X | Psychologist | PY4064 | FL |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PY4064 | FL |
N | 103G00000X | Clinical Psychologist | PY4064 | FL |
N | 103TC0700X | Clinical Psychologist | PY4064 | FL |
N | 103TF0200X | Forensic Psychologist | PY4064 | FL |
N | 103TR0400X | Rehabilitation Psychologist | PY4064 | FL |
NPI | 1417014069 |
---|---|
Provider Name | Dr. David Lee Butler |
First Address | North Miami Beach, FL 33179-5035 |
Second Address | North Miami Beach, FL 33179-5035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 13/09/2008 |