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General NPI Number Information
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NPI Number | 1356580955
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Entity Type | Organization
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Legal Business Name | LYNDA GURVITZ PHD INC
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Dates
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Enumeration Date | 02/05/2009
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Last Update Date | 04/27/2009
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Provider Practice Location Address
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Address Line | 801 W BAY DR SUITE 607
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City | LARGO
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State | FL
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Zip | 33770-3269
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Country | US
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Telephone | 727-585-7164
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Fax | 727-585-0894
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Provider Business Mailing Address
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Address Line | 801 W BAY DR SUITE 607
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City | LARGO
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State | FL
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Zip | 33770-3269
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Country | US
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Telephone | 727-585-7164
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LYNDA IRENE GURVITZ
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Credential | PH.D.
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Telephone | 727-585-7164
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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 |
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License Number State |
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