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General NPI Number Information
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NPI Number | 1770967309
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Entity Type | Organization
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Legal Business Name | PSYCHOLOGICAL SERVICES & CONSULTATIONS, LLC
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Dates
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Enumeration Date | 07/14/2015
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Last Update Date | 07/14/2015
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Provider Practice Location Address
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Address Line | 5481 SW 60TH ST SUITE 502
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City | OCALA
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State | FL
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Zip | 34474-7698
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Country | US
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Telephone | 352-804-1846
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Fax | 352-509-7196
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Provider Business Mailing Address
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Address Line | 5481 SW 60TH ST SUITE 502
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City | OCALA
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State | FL
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Zip | 34474-7698
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Country | US
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Telephone | 352-804-1846
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Fax | 352-509-7196
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DR. MOHAMED KHAN
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Credential | PSYD
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Telephone | 352-804-1846
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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 | PY8523
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License Number State | FL
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