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General NPI Number Information
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NPI Number | 1154102614
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Entity Type | Organization
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Legal Business Name | CLARITY PSYCHOLOGICAL TESTING PLCC
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Dates
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Enumeration Date | 10/11/2023
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 12627 SAN JOSE BLVD STE 301
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City | JACKSONVILLE
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State | FL
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Zip | 32223-8639
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Country | US
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Telephone | 904-736-2736
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Fax |
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Provider Business Mailing Address
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Address Line | 881 BENT CREEK DR
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City | ST JOHNS
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State | FL
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Zip | 32259-8253
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Country | US
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Telephone | 310-351-4460
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. LISA BLUM
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Credential | PHD
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Telephone | 310-351-4460
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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