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General NPI Number Information
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NPI Number | 1568683555
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Entity Type | Organization
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Legal Business Name | FAITH S SPERRY PSY D PA
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2787 E OAKLAND PARK BLVD STE 201
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-1630
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Country | US
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Telephone | 954-327-8999
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Fax | 954-565-6178
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Provider Business Mailing Address
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Address Line | 2787 E OAKLAND PARK BLVD STE 201
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City | FORT LAUDERDALE
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State | FL
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Zip | 33306-1630
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Country | US
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Telephone | 954-327-8999
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Fax | 954-565-6178
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Authorized Official
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Title or Position | OWNER
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Name | DR. FAITH SPERRY
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Credential | PSY.D.
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Telephone | 954-327-8999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY4342
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License Number State | FL
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