Provider Demographics
NPI:1093170672
Name:ALICE E RICHMAN
Entity Type:Organization
Organization Name:ALICE E RICHMAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:561-797-2666
Mailing Address - Street 1:900 E INDIANTOWN RD
Mailing Address - Street 2:SUITE 116
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-5165
Mailing Address - Country:US
Mailing Address - Phone:561-776-1066
Mailing Address - Fax:
Practice Address - Street 1:900 E INDIANTOWN RD
Practice Address - Street 2:SUITE 116
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-5165
Practice Address - Country:US
Practice Address - Phone:561-776-1066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-23
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7712103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty