| Psychological Management Group, Pa | |
|
15436 N Florida Ave Ste 102 Tampa FL 33613-1225 | |
| (813) 963-1016 | |
| (813) 961-6591 |
| Full Name | Psychological Management Group, Pa |
|---|---|
| Speciality | Psychologist - Counseling |
| Location | 15436 N Florida Ave Ste 102, Tampa, Florida |
| Authorized Official Name and Position | Robert C. Wright (DIRECTOR) |
| Authorized Official Contact | 8139631016 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychological Management Group, Pa 15436 N Florida Ave Ste 102 Tampa FL 33613-1225 Ph: (813) 963-1016 | Psychological Management Group, Pa 15436 N Florida Ave Ste 102 Tampa FL 33613-1225 Ph: (813) 963-1016 |
| NPI Number | 1144384264 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 05/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144384264 | NPI | - | NPPES |
| 94978 | Other | FL | BC BS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | PY4542 (Florida) | Primary |
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