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General NPI Number Information
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NPI Number | 1215092911
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Entity Type | Organization
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Legal Business Name | STUART NOVICK PH.D.,P.A.
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Dates
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Enumeration Date | 12/25/2006
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Last Update Date | 06/07/2012
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Provider Practice Location Address
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Address Line | 14021 N DALE MABRY HWY
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City | TAMPA
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State | FL
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Zip | 33618-2401
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Country | US
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Telephone | 813-960-0403
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Fax | 813-960-4790
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Provider Business Mailing Address
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Address Line | 14021 N DALE MABRY HWY
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City | TAMPA
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State | FL
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Zip | 33618-2401
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Country | US
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Telephone | 813-960-0403
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Fax | 813-960-4790
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STUART NOVICK
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Credential | PH.D.
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Telephone | 813-960-0403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT197
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License Number State | FL
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