Organization
PSYCHOLOGICAL AND NEUROBEHAVIORAL SERVICES P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY G. HENLEY PSY D (PRESIDENT)
(863) 701-9202
Entity
Organization
Contact information
Practice address
4720 CLEVELAND HEIGHTS BLVD, SUITE 105, LAKELAND, FL 33813-2243
(863) 701-9202
(863) 701-9262
Mailing address
4720 CLEVELAND HEIGHTS BLVD, SUITE 105, LAKELAND, FL 33813-2243
(863) 701-9202
(863) 701-9262
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
Other
Enumeration date
12/08/2006
Last updated
06/05/2008
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