Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PY7496 | FL |
NPI | 1093835761 |
---|---|
Provider Name | Dr. Michelle Renee Hintz |
First Address | Hollywood, FL 33021-6917 |
Second Address | Hollywood, FL 33021-6917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 27/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1093835761 | (02) | FL |
1134249816 | (02) | FL |