Provider Demographics
NPI:1235314287
Name:GILBERT, ALYSE MICHELLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALYSE
Middle Name:MICHELLE
Last Name:GILBERT
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 1:13753 NW 22ND PL
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-5310
Mailing Address - Country:US
Mailing Address - Phone:954-224-8784
Mailing Address - Fax:
Practice Address - Street 1:13753 NW 22ND PL
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-5310
Practice Address - Country:US
Practice Address - Phone:954-224-8784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2023-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7644103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical