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General NPI Number Information
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NPI Number | 1114501731
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Entity Type | Individual
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Provider Name | TERRENCE ROOSEVELT PARTEE PSY.D
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Gender | Male
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Dates
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Enumeration Date | 05/10/2021
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 3700 NW 111TH PL
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City | OCALA
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State | FL
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Zip | 34482-1480
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Country | US
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Telephone | 352-840-7936
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Fax |
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Provider Business Mailing Address
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Address Line | 1512 E 12TH AVE UNIT 131
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City | TAMPA
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State | FL
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Zip | 33605-3527
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Country | US
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Telephone | 317-551-3719
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY11039
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License Number State | FL
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