Provider Demographics
NPI:1730268012
Name:VAN HASSELT, VINCENT BRAM (PHD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:BRAM
Last Name:VAN HASSELT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3301 COLLEGE AVE
Mailing Address - Street 2:CENTER FOR PSYCHOLOGICAL STUDIES
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-7721
Mailing Address - Country:US
Mailing Address - Phone:954-262-5752
Mailing Address - Fax:954-262-3857
Practice Address - Street 1:3301 COLLEGE AVE
Practice Address - Street 2:CENTER FOR PSYCHOLOGICAL STUDIES
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-7721
Practice Address - Country:US
Practice Address - Phone:954-262-5752
Practice Address - Fax:954-262-3857
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 5020103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical