Organization
BILL BRACKER PSYD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM BRACKER JR. PSY.D. (OWNER)
95456621166
Entity
Organization
Contact information
Practice address
915 MIDDLE RIVER DRIVE, SUITE 307, FORT LAUDERDALE, FL 33304-3560
(954) 566-2166
(954) 566-1186
Mailing address
915 MIDDLE RIVER DRIVE, SUITE 307, FORT LAUDERDALE, FL 33304-3560
(954) 566-2166
(954) 566-1186
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006L
BCBS
FL
Enumeration date
02/26/2009
Last updated
10/15/2011
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