Organization
DR. LEORA GARDNER,PH.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEORA J. GARDNER PH.D. (PRESIDENT)
(561) 414-1650
Entity
Organization
Contact information
Practice address
2600 N MILITARY TRL, SUITE 270, BOCA RATON, FL 33431-6312
(561) 414-1650
(561) 241-4943
Mailing address
2600 N MILITARY TRL, SUITE 270, BOCA RATON, FL 33431-6312
(561) 414-1650
(561) 241-4943
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY0005116
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PY0005116
LICENSE
FL
Enumeration date
11/06/2006
Last updated
08/22/2020
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