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General NPI Number Information
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NPI Number | 1740553031
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Entity Type | Organization
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Legal Business Name | STAN J. STRYCHARZ, PSY.D., P.A.
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Dates
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Enumeration Date | 02/16/2012
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Last Update Date | 02/16/2012
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Provider Practice Location Address
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Address Line | 26811 S BAY DR SUITE 300
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-4394
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Country | US
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Telephone | 239-992-4300
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Fax | 239-495-9424
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Provider Business Mailing Address
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Address Line | 26811 S BAY DR SUITE 300
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-4394
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Country | US
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Telephone | 239-992-4300
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Fax | 239-495-9424
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Authorized Official
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Title or Position | OWNER
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Name | DR. STAN J. STRYCHARZ
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Credential | PSY.D.
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Telephone | 239-992-4300
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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 | PY8341
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License Number State | FL
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