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General NPI Number Information
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NPI Number | 1568621753
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Entity Type | Organization
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Legal Business Name | TRIPLETT PROFESSIONAL SERVICES, INC.
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Dates
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Enumeration Date | 06/03/2008
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 1443 MORGANWOOD DR
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City | LAKELAND
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State | FL
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Zip | 33801-2824
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Country | US
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Telephone | 863-370-3331
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Fax | 863-701-2196
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Provider Business Mailing Address
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Address Line | 1443 MORGANWOOD DR
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City | LAKELAND
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State | FL
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Zip | 33801-2824
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Country | US
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Telephone | 863-370-3331
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Fax | 863-701-2196
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. GEORGE E. TRIPLETT
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Credential | PH.D.
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Telephone | 863-370-3331
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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 | PY6110
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License Number State | FL
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