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Contact Information

LEESBURG PSYCHOLOGY
8529 US HIGHWAY 441
LEESBURG, FL34788-4021
 Phone: 352-787-7144
 Fax: 352-450-7600
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for LEESBURG PSYCHOLOGY · (Female)

NPI Number 1710204292
Status Active
Credentials
Entity Individual
Enumeration date 04/23/2010
Last updated 05/10/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • FL License # PY4794
  • FL Other 59515 BLUE CROSS AND BLUE SHIELD OF FLORIDA
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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