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General NPI Number Information
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NPI Number | 1265471601
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Entity Type | Organization
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Legal Business Name | BILINGUAL PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3380 W 4TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-4350
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Country | US
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Telephone | 305-527-8094
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Fax | 305-575-7133
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Provider Business Mailing Address
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Address Line | 3380 W 4TH AVE
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City | HIALEAH
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State | FL
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Zip | 33012-4350
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Country | US
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Telephone | 305-527-8094
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Fax | 305-575-7133
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. SHIRLEY AMANDA GAZABON
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Credential | PH.D.
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Telephone | 305-527-8094
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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 | PY 7129
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License Number State | FL
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