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General NPI Number Information
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NPI Number | 1972821635
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Entity Type | Organization
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Legal Business Name | CATHY L ROBERTS PSYD
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Dates
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Enumeration Date | 05/05/2010
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Last Update Date | 05/05/2010
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Provider Practice Location Address
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Address Line | 7376 NW 5TH ST
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City | PLANTATION
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State | FL
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Zip | 33317-1605
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Country | US
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Telephone | 954-461-5690
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Fax |
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Provider Business Mailing Address
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Address Line | 4301 S FLAMINGO RD NO 103-128
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City | DAVIE
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State | FL
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Zip | 33330-1902
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Country | US
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Telephone | 954-461-5690
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Fax | 954-236-9724
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CATHY L ROBERTS
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Credential | PSY.D.
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Telephone | 954-461-5690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | PY7411
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License Number State | FL
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