Healthcare Provider Details

I. General information

NPI: 1669425559
Provider Name (Legal Business Name): HALINA HERMAN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 06/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 ALT 19 C
PALM HARBOR FL
34683-5303
US

IV. Provider business mailing address

350 ALT 19 C
PALM HARBOR FL
34683-5303
US

V. Phone/Fax

Practice location:
  • Phone: 727-254-9183
  • Fax: 888-345-7010
Mailing address:
  • Phone: 722-254-9183
  • Fax: 888-345-7010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY8896
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: