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Organization
BARRY BRODY PHD LLC
Active
Organization
BARRY BRODY PHD LLC
Active
Other names
Dr. Brody LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY BRODY PH.D. (MANAGER-MEMBER)
(386) 755-1720
Entity
Organization
Contact information
Practice address
871 SW STATE ROAD 47, LAKE CITY, FL 32025-0433
(386) 755-1720
(386) 754-1325
Mailing address
871 SW STATE ROAD 47, LAKE CITY, FL 32025-0433
(386) 755-1720
(386) 754-1325
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
MT983
FL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
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Other
Enumeration date
01/01/2015
Last updated
09/27/2023
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