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General NPI Number Information
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NPI Number | 1487842175
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL PSYCHOLOGICAL SERVICES INC
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 07/08/2013
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Provider Practice Location Address
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Address Line | 1108 KANE CONCOURSE SUITE 207
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City | BAY HARBOR ISLANDS
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State | FL
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Zip | 33154-2068
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Country | US
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Telephone | 305-606-5093
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Fax | 305-285-9430
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Provider Business Mailing Address
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Address Line | 1108 KANE CONCOURSE SUITE 207
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City | BAY HARBOR ISLANDS
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State | FL
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Zip | 33154-2068
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Country | US
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Telephone | 305-606-5093
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Fax | 305-285-9430
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALISON BETH GROSSMAN
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Credential | PH.D.
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Telephone | 305-606-5093
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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 | PY6417
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License Number State | FL
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