Organization
CENTRAL FLORIDA PSYCHOLOGICAL SERVICES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY T HOLCOMB PSY.D. (PRESIDENT)
(407) 347-4676
Entity
Organization
Contact information
Practice address
125 W PINEVIEW ST, SUITE 1005, ALTAMONTE SPRINGS, FL 32714-2007
(407) 951-6920
Mailing address
125 W PINEVIEW ST, SUITE 1005, ALTAMONTE SPRINGS, FL 32714-2007
(407) 951-6920
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
PY0004613
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59488
MEDICARE
FL
Enumeration date
05/11/2011
Last updated
11/30/2011
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