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General NPI Number Information
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NPI Number | 1629545629
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Entity Type | Organization
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Legal Business Name | DEBRA LYNN STIBICK, PH.D., LLC
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Dates
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Enumeration Date | 10/28/2018
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Last Update Date | 10/28/2018
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Provider Practice Location Address
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Address Line | 8130 66TH ST N STE 10
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City | PINELLAS PARK
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State | FL
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Zip | 33781-2111
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Country | US
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Telephone | 520-490-2040
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Fax | 727-565-4188
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Provider Business Mailing Address
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Address Line | PO BOX 3236
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City | SEMINOLE
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State | FL
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Zip | 33775-3236
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Country | US
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Telephone | 520-490-2040
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Fax | 727-565-4188
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | DR. DEBRA LYNN STIBICK
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Credential | PHD
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Telephone | 520-490-2040
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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 |
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License Number State |
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