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Individual

DR. ELAINE SANDRA BERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
EDD PSYCHOLOGIST

Contact information

Practice address
1712 LAGO VISTA BLVD, PALM HARBOR, FL 34685-3348
(727) 784-8392
(727) 784-8392
Mailing address
1712 LAGO VISTA BLVD, PALM HARBOR, FL 34685-3348
(727) 784-8392
(727) 784-8392

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
3990
OH
103TC0700X
Clinical Psychologist
Primary
PY6951
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31124508300
BWC
Enumeration date
12/08/2006
Last updated
02/03/2010
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