| Medical Psychology Center Pa | |
|
570 Memorial Cir Ste 150 Ormond Beach FL 32174-5002 | |
| (386) 672-9250 | |
| (386) 672-9251 |
| Full Name | Medical Psychology Center Pa |
|---|---|
| Speciality | Psychologist |
| Location | 570 Memorial Cir, Ormond Beach, Florida |
| Authorized Official Name and Position | Katherine Marie Billiot (PRESIDENT) |
| Authorized Official Contact | 3866729250 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Psychology Center Pa 570 Memorial Cir Ste 150 Ormond Beach FL 32174-5002 Ph: (386) 672-9250 | Medical Psychology Center Pa 570 Memorial Cir Ste 150 Ormond Beach FL 32174-5002 Ph: (386) 672-9250 |
| NPI Number | 1881891174 |
|---|---|
| Provider Enumeration Date | 06/29/2007 |
| Last Update Date | 01/16/2009 |
| Medicare PECOS PAC ID | 8022027044 |
|---|---|
| Medicare Enrollment ID | O20060419000202 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881891174 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY7252 (Florida) | Primary |
| Provider Name | Katherine M Billiot |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851357990 PECOS PAC ID: 6103835129 Enrollment ID: I20060420000103 |
| Provider Name | Sofia S Yahya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770540551 PECOS PAC ID: 1052596970 Enrollment ID: I20110419000630 |
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