Individual
JACQUELINE CHRISTINE MAHFOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3100 SW 62ND AVE, MIAMI, FL 33155-3009
(786) 624-3640
Mailing address
3100 SW 62ND AVE, MIAMI, FL 33155-3009
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
11412
FL
103TC2200X
Clinical Child & Adolescent Psychologist
11412
FL
Other
Enumeration date
09/12/2022
Last updated
02/21/2023
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