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General NPI Number Information
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NPI Number | 1508267717
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Entity Type | Organization
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Legal Business Name | OPPENHEIMER PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 09/07/2014
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Last Update Date | 09/07/2014
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Provider Practice Location Address
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Address Line | 908 E GILCHRIST ST
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City | PLANT CITY
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State | FL
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Zip | 33563-3609
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Country | US
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Telephone | 813-966-8456
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Fax |
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Provider Business Mailing Address
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Address Line | 908 E GILCHRIST ST
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City | PLANT CITY
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State | FL
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Zip | 33563-3609
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Country | US
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Telephone | 813-966-8456
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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. TANYA OPPENHEIMER
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Credential | PSY.D.
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Telephone | 813-966-8456
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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 | PY 6879
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License Number State | FL
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