Individual
DR. NICOLE BLANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2840 SW 3RD AVE, MIAMI, FL 33129-2317
(305) 857-0050
Mailing address
2840 SW 3RD AVE, MIAMI, FL 33129-2317
(305) 857-0050
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY9074
FL
Other
Enumeration date
09/08/2014
Last updated
09/08/2014
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