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General NPI Number Information
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NPI Number | 1881748044
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Entity Type | Individual
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Provider Name | PATRICK PHIPPS PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 624 W TROPICAL WAY
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City | PLANTATION
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State | FL
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Zip | 33317-3348
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Country | US
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Telephone | 954-584-6155
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Fax | 954-316-7553
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Provider Business Mailing Address
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Address Line | 31 SW 12TH ST
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City | DANIA BEACH
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State | FL
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Zip | 33004-4226
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Country | US
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Telephone | 954-214-9299
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Fax | 954-925-9333
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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 | PY6402
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License Number State | FL
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