Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | PY7796 | FL |
N | 103TC0700X | Clinical Psychologist | PY7796 | FL |
Y | 103TF0200X | Forensic Psychologist | PY7796 | FL |
NPI | 1003055161 |
---|---|
Provider Name | Dr. Yaakov Siegel |
First Address | North Miami Beach, FL 33162-4883 |
Second Address | North Miami Beach, FL 33162-4883 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2009 |
Last Update Date | 12/02/2009 |