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General NPI Number Information
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NPI Number | 1265655617
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Entity Type | Organization
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Legal Business Name | AFFILIATED HEALTH PSYCHOLOGISTS
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 04/01/2008
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Provider Practice Location Address
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Address Line | 14011 BEACH BLVD SUITE 100
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City | JACKSONVILLE
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State | FL
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Zip | 32250-1507
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Country | US
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Telephone | 904-223-4865
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Fax | 904-223-4868
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Provider Business Mailing Address
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Address Line | 14011 BEACH BLVD SUITE 100
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City | JACKSONVILLE
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State | FL
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Zip | 32250-1507
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Country | US
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Telephone | 904-223-4865
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Fax | 904-223-4868
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Authorized Official
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Title or Position | PSYCHOLOGIST OWNER
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Name | EILEEN KRIMSKY
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Credential |
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Telephone | 904-223-4865
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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 | PY3479
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY3475
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License Number State | FL
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