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General NPI Number Information
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NPI Number | 1457532764
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Entity Type | Individual
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Provider Name | ISRA M SALEH-MOHD PSYD
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Gender | Female
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 07/31/2008
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Provider Practice Location Address
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Address Line | 18958 DALE MABRY HWY N SUITE102
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City | LUTZ
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State | FL
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Zip | 33548-4911
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Country | US
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Telephone | 813-541-9096
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Fax | 813-319-3933
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Provider Business Mailing Address
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Address Line | 7812 BALLY MONEY RD
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City | TAMPA
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State | FL
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Zip | 33610-8067
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Country | US
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Telephone | 813-541-9096
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Fax | 813-319-3933
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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 | PY7588
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License Number State | FL
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