Organization
LARISA PALMER, PSY.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARISA PALMER PSY.D. (PRESIDENT)
(954) 925-3191
Entity
Organization
Contact information
Practice address
210 S FEDERAL HWY, SUITE 302, HOLLYWOOD, FL 33020-6811
(954) 925-3191
Mailing address
210 S FEDERAL HWY, SUITE 302, HOLLYWOOD, FL 33020-6811
(954) 925-3191
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PY7753
FL
103TF0200X
Forensic Psychologist
PY7753
FL
Other
Enumeration date
03/13/2012
Last updated
03/13/2012
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