Individual
DR. GRACE ELIZABETH SIDBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
300 S PINE ISLAND RD, SUITE 227, PLANTATION, FL 33324-2673
(954) 382-4889
(954) 382-4884
Mailing address
300 S PINE ISLAND RD, SUITE 227, PLANTATION, FL 33324-2673
(954) 382-4889
(954) 382-4884
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 6164
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
65-0991291
TRICARE
FL
01
—
SIDBGRAC
CORPHEALTH PROVIDER #
FL
Enumeration date
07/29/2006
Last updated
10/15/2008
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