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General NPI Number Information
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NPI Number | 1417154055
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Entity Type | Individual
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Provider Name | SANDRA DERIS ATASSI PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 06/28/2007
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 8333 NW 53RD ST STE 450
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City | DORAL
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State | FL
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Zip | 33166-4837
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Country | US
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Telephone | 305-213-2842
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Fax | 305-597-0119
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Provider Business Mailing Address
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Address Line | 6108 NW 113TH PL
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City | DORAL
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State | FL
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Zip | 33178-3607
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Country | US
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Telephone | 305-213-2842
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Fax | 305-597-0119
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY7335
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License Number State | FL
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