Individual
DR. SAMANTHA BRYN MACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
10205 S DIXIE HWY STE 203, PINECREST, FL 33156-3168
(305) 662-2686
Mailing address
413 E PALMETTO PARK RD APT 443, BOCA RATON, FL 33432-5185
(954) 600-5405
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY11220
FL
Other
Enumeration date
08/30/2021
Last updated
08/30/2021
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