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Organization

JANIE THOMAS KONDELL, PSY.D., P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JANIE THOMAS KONDELL PSY.D. (PRESIDENT)
(954) 962-0454
Entity
Organization

Contact information

Practice address
3325 HOLLYWOOD BLVD, SUITE 203, HOLLYWOOD, FL 33021-6999
(954) 962-0454
(954) 962-0989
Mailing address
3325 HOLLYWOOD BLVD, SUITE 203, HOLLYWOOD, FL 33021-6999
(954) 962-0454
(954) 962-0989

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY5414
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1770640427
INDIVIDUAL PRACTITIONER
FL
01
177064427
INDIVIDUAL PRACTITIONER
FL
Enumeration date
02/25/2013
Last updated
02/25/2013
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