Provider Demographics
NPI:1114036399
Name:LOUGACHI, BERYL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BERYL
Middle Name:
Last Name:LOUGACHI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 NE MIAMI GARDENS DR
Mailing Address - Street 2:SUITE 509
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4836
Mailing Address - Country:US
Mailing Address - Phone:305-785-5757
Mailing Address - Fax:305-919-8119
Practice Address - Street 1:1550 NE MIAMI GARDENS DR
Practice Address - Street 2:SUITE 509
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-4836
Practice Address - Country:US
Practice Address - Phone:305-785-5757
Practice Address - Fax:305-919-8119
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4581103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist