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General NPI Number Information
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NPI Number | 1881142644
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Entity Type | Individual
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Provider Name | AMBER POPOVITZ-GALE PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 09/21/2016
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 2454 E MICHIGAN ST STE 110
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City | ORLANDO
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State | FL
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Zip | 32806-5059
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Country | US
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Telephone | 863-591-6556
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Fax | 312-616-8112
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Provider Business Mailing Address
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Address Line | 6100 LAKE ELLENOR RD SUITE 151 #1271
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City | ORLANDO
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State | FL
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Zip | 32809
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Country | US
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Telephone | 402-369-4835
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Fax | 312-616-8112
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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 | PY10793
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY.10793
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License Number State | FL
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