Individual
DR. SARAH TISTSI MBIZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, OTR/L, CRC
Contact information
Practice address
12941 NW 2ND ST, PEMBROKE PINES, FL 33028-2295
(954) 271-2730
Mailing address
8958 W STATE ROAD 84 # 261, DAVIE, FL 33324-4457
(954) 271-2730
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY10089
FL
225X00000X
Occupational Therapist
OT-8092
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
888716100
—
FL
Enumeration date
02/18/2007
Last updated
11/13/2020
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