Individual
MS. STEPHANIE GANSERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
15127 JOG RD, SUITE 106, DELRAY BEACH, FL 33446-1251
(561) 495-6300
(561) 495-8877
Mailing address
1830 SW 36TH AVE, FORT LAUDERDALE, FL 33312-3631
(954) 540-4960
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY6817
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PY6817
STATE LICENSE FL
FL
Enumeration date
07/01/2006
Last updated
07/08/2007
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