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Organization

CHARU JAIN, PSY.D. LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARU JAIN PSY.D. (PRESIDENT)
(954) 817-6372
Entity
Organization

Contact information

Practice address
7420 NW 5TH ST, SUITE 103, PLANTATION, FL 33317-1611
(954) 817-6372
(954) 587-8686
Mailing address
7420 NW 5TH ST, SUITE 103, PLANTATION, FL 33317-1611
(954) 817-6372
(954) 587-8686

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY9137
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PY9137
LICENCE NUMBER
FL
Enumeration date
10/19/2016
Last updated
10/19/2016
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