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General NPI Number Information
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NPI Number | 1639947070
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Entity Type | Individual
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Provider Name | CORY AUSTIN SAFRA PSYD
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Gender | Male
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Dates
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Enumeration Date | 12/14/2023
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Last Update Date | 12/14/2023
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Provider Practice Location Address
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Address Line | 32 SE 2ND AVE UNIT 610
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City | DELRAY BEACH
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State | FL
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Zip | 33444-3643
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Country | US
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Telephone | 561-600-8835
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Fax |
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Provider Business Mailing Address
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Address Line | 32 SE 2ND AVE UNIT 610
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City | DELRAY BEACH
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State | FL
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Zip | 33444-3643
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Country | US
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Telephone | 954-235-1571
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | PY9888
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License Number State | FL
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