Organization
LORRAINE D. DISTON PSYD.,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LORRAINE D DISTON PSYD (OWNER)
(305) 905-3794
Entity
Organization
Contact information
Practice address
10305 NW 41ST ST, SUITE 202, DORAL, FL 33178-2396
(305) 905-3794
(305) 829-2284
Mailing address
7324 BAY HILL DR, HIALEAH, FL 33015-2208
(305) 905-3794
(305) 829-2284
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY4470
FL
Other
Enumeration date
07/02/2014
Last updated
07/16/2014
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