Organization
AUTHENTIC BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYDIA ROSA MALCOLM PHD (OWNER)
(954) 715-5477
Entity
Organization
Contact information
Practice address
9050 PINES BLVD STE 450-00, PEMBROKE PINES, FL 33024-6455
(954) 715-5477
Mailing address
18459 PINES BLVD STE 120, PEMBROKE PINES, FL 33029-1400
(954) 715-5477
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY10094
FL
Other
Enumeration date
03/13/2018
Last updated
01/12/2022
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