Organization
INTROSPECTIVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SONNY ETIENNE LMHC (OWNER)
(754) 281-0749
Entity
Organization
Contact information
Practice address
8400 N UNIVERSITY DR STE 114, TAMARAC, FL 33321-1700
(954) 774-2201
(954) 827-0988
Mailing address
8400 N UNIVERSITY DR STE 114, TAMARAC, FL 33321-1700
(954) 774-2201
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/09/2017
Last updated
11/15/2019
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