Provider Demographics
NPI:1023246402
Name:L. DENNISON REED, PSY.D., P.A.
Entity type:Organization
Organization Name:L. DENNISON REED, PSY.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:DENNISON
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-427-8883
Mailing Address - Street 1:4710 NW BOCA RATON BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4879
Mailing Address - Country:US
Mailing Address - Phone:954-427-8883
Mailing Address - Fax:954-427-3813
Practice Address - Street 1:4710 NW BOCA RATON BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4879
Practice Address - Country:US
Practice Address - Phone:954-427-8883
Practice Address - Fax:954-427-3813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3365103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty