Provider Demographics
NPI:1114080702
Name:MURRAY, MARY LIZABETH (PSY D)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:LIZABETH
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10333 SEMINOLE BLVD
Mailing Address - Street 2:SUITE #6
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33778-4210
Mailing Address - Country:US
Mailing Address - Phone:727-319-3020
Mailing Address - Fax:727-319-3040
Practice Address - Street 1:10333 SEMINOLE BLVD
Practice Address - Street 2:SUITE #6
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33778-4210
Practice Address - Country:US
Practice Address - Phone:727-319-3020
Practice Address - Fax:727-319-3040
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4634103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73970Medicare ID - Type Unspecified