Organization
TINA DICICCO REYNOLDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA DICICCO REYNOLDS PSY.D. (PSYCHOLOGIST/OWNER)
(954) 787-9711
Entity
Organization
Contact information
Practice address
11401 NW 14TH CT, PEMBROKE PINES, FL 33026
(954) 787-9711
(954) 787-8116
Mailing address
11401 NW 14TH CT, PEMBROKE PINES, FL 33026-2505
(954) 249-1871
(954) 787-9711
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 7384
FL
Other
Enumeration date
09/12/2011
Last updated
05/06/2021
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