Organization
KENSHO WELLNESS GROUP, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDD BRAZER (GENERAL MANAGER)
(800) 990-0340
Entity
Organization
Contact information
Practice address
3550 POWERLINE RD, FT LAUDERDALE, FL 33309-5919
(855) 972-8674
Mailing address
3550 POWERLINE RD, FT LAUDERDALE, FL 33309-5919
(855) 972-8674
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Enumeration date
01/07/2014
Last updated
01/14/2016
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