Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY0004910 | FL |
Y | 103TC0700X | Clinical Psychologist | PY0004910 | FL |
NPI | 1003988072 |
---|---|
Provider Name | Sandy Bernstein |
First Address | Fort Lauderdale, FL 33309-2069 |
Second Address | Fort Lauderdale, FL 33309-2069 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 08/07/2007 |