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General NPI Number Information
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NPI Number | 1407497365
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Entity Type | Individual
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Provider Name | CARLY GIRNUN PSYD
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Gender | Female
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Dates
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Enumeration Date | 10/02/2019
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 10205 S DIXIE HWY STE 203
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City | PINECREST
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State | FL
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Zip | 33156-3168
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Country | US
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Telephone | 305-662-2686
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Fax |
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Provider Business Mailing Address
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Address Line | 13091 SW 78TH AVE
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City | PINECREST
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State | FL
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Zip | 33156-6125
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY12955
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License Number State | FL
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