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Cd Psychological Practice, PA

Psychologist in Fort Myers, FL. Organization (NPI-2).

NPI number1114348794
StatusActive
Last updated in NPPESSep 18, 2014

Details

NPI
1114348794
Entity type
Organization (NPI-2)
Legal business name
Cd Psychological Practice, PA
Organization subpart
No
Enumeration date
Dec 26, 2013
Last updated
Sep 18, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103T00000X PsychologistMH 10313FLYes
101YM0800X Counselor, Mental HealthMH 10313FL

Practice location

1937 Grace Ave Ste 100
Fort Myers, FL 33901-7119

Phone 239-340-5589

Mailing address

118-35 Queens Blvd
Suite 1403
Forest Hills, NY 11375-7205

Phone 718-268-6600 · Fax 718-268-6065

Authorized official

Cynthia Davey
Psychologist
7182686600

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