Organization
ROBERT BLACKGROVE, PSY.D. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT BLACKGROVE PSY.D. (OWNER)
(305) 964-5921
Entity
Organization
Contact information
Practice address
8305 SW 160TH ST, PALMETTO BAY, FL 33157-3642
(305) 964-5921
Mailing address
8305 SW 160TH ST, PALMETTO BAY, FL 33157-3642
(305) 964-5921
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
06/22/2020
Last updated
06/22/2020
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