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Organization

PHOENIX PSYCHSOLUTIONS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALINA M CLAVIJO PH.D., HSPP (AUTHORIZED OFFICIAL/REGISTEREDAGENT)
(954) 374-3636
Entity
Organization

Contact information

Practice address
8362 SW 8TH ST, MIAMI, FL 33144-4180
(317) 370-5017
Mailing address
7775 YARDLEY DR APT F105, TAMARAC, FL 33321-0849
(317) 370-5017

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
103TB0200X
Cognitive & Behavioral Psychologist
103TC0700X
Clinical Psychologist
Primary
103TC1900X
Counseling Psychologist

Other

Enumeration date
03/22/2019
Last updated
05/07/2019
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