Provider Demographics
NPI:1710288717
Name:LLOYD, GRISSEL M (PSYD, LMHC, BCBA)
Entity type:Individual
Prefix:DR
First Name:GRISSEL
Middle Name:M
Last Name:LLOYD
Suffix:
Gender:F
Credentials:PSYD, LMHC, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11906 BOYETTE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-5601
Mailing Address - Country:US
Mailing Address - Phone:813-609-2034
Mailing Address - Fax:813-609-2038
Practice Address - Street 1:11906 BOYETTE RD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-5601
Practice Address - Country:US
Practice Address - Phone:813-609-2034
Practice Address - Fax:813-609-2038
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-06
Last Update Date:2024-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH7514101YM0800X
FL1-04-1968103K00000X
FLPY11248103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst