Organization
SOUTH FLORIDA NEURO WELLNESS CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELLY LAHN MBR (OWNER)
(954) 284-0025
Entity
Organization
Contact information
Practice address
5337 ORANGE DR, DAVIE, FL 33314-3815
(954) 284-0025
(954) 252-4037
Mailing address
6191 ORANGE DR, DAVIE, FL 33314-3449
(954) 284-0025
(954) 252-4037
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MT3051
FL
103G00000X
Clinical Neuropsychologist
PY6992
FL
103TC0700X
Clinical Psychologist
PY6992
FL
106H00000X
Marriage & Family Therapist
MT2760
FL
305S00000X
Point of Service
Primary
—
FL
Other
Enumeration date
10/26/2016
Last updated
04/24/2017
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