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General NPI Number Information
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NPI Number | 1164727814
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Entity Type | Organization
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Legal Business Name | PHIL HELLER, PSY.D., P.A.
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Dates
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Enumeration Date | 01/11/2011
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Last Update Date | 01/11/2011
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Provider Practice Location Address
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Address Line | 2200 NW CORPORATE BLVD SUITE 110
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City | BOCA RATON
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State | FL
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Zip | 33431-7387
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Country | US
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Telephone | 561-994-4565
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Fax | 561-994-3552
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Provider Business Mailing Address
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Address Line | 2200 NW CORPORATE BLVD SUITE 110
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City | BOCA RATON
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State | FL
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Zip | 33431-7387
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Country | US
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Telephone | 561-994-4565
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Fax | 561-994-3552
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. PHIL HELLER
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Credential | PSY.D.
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Telephone | 561-994-4565
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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 | PY3822
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License Number State | FL
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