Provider Demographics
NPI:1174746192
Name:MARY L MURRAY PSYD PA
Entity type:Organization
Organization Name:MARY L MURRAY PSYD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LIZABETH
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:727-319-3020
Mailing Address - Street 1:10333 SEMINOLE BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-4210
Mailing Address - Country:US
Mailing Address - Phone:727-319-3020
Mailing Address - Fax:727-319-3040
Practice Address - Street 1:10333 SEMINOLE BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-4210
Practice Address - Country:US
Practice Address - Phone:727-319-3020
Practice Address - Fax:727-319-3040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4634103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty