| Dynamic Outpatient Therapeutic Services, Llc | |
|
2312 Wilton Dr Wilton Manors FL 33305-1249 | |
| (954) 745-7917 | |
| (954) 745-7918 |
| Full Name | Dynamic Outpatient Therapeutic Services, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2312 Wilton Dr, Wilton Manors, Florida |
| Authorized Official Name and Position | Shayna Rayman (MANAGING MEMBER) |
| Authorized Official Contact | 9547457917 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynamic Outpatient Therapeutic Services, Llc 2312 Wilton Dr Wilton Manors FL 33305-1249 Ph: (954) 745-7917 | Dynamic Outpatient Therapeutic Services, Llc 2312 Wilton Dr Wilton Manors FL 33305-1249 Ph: (954) 745-7917 |
| NPI Number | 1073989273 |
|---|---|
| Provider Enumeration Date | 08/11/2015 |
| Last Update Date | 08/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073989273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH 11511 (Florida) | Primary |
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