| Heather Jordon Clark Phd Llc | |
|
600 Sw 3rd St Suite 2270 Pompano Beach FL 33060-6932 | |
| (954) 960-8900 | |
| (954) 960-8888 |
| Full Name | Heather Jordon Clark Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 600 Sw 3rd St, Pompano Beach, Florida |
| Authorized Official Name and Position | Heather Jordon Clark (OWNER) |
| Authorized Official Contact | 9549608900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heather Jordon Clark Phd Llc 600 Sw 3rd St Suite 2270 Pompano Beach FL 33060-6932 Ph: (954) 960-8900 | Heather Jordon Clark Phd Llc 600 Sw 3rd St Suite 2270 Pompano Beach FL 33060-6932 Ph: (954) 960-8900 |
| NPI Number | 1740456300 |
|---|---|
| Provider Enumeration Date | 05/05/2008 |
| Last Update Date | 09/20/2010 |
| Medicare PECOS PAC ID | 3779653696 |
|---|---|
| Medicare Enrollment ID | O20080604000520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740456300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY 7620 (Florida) | Primary |
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