Provider Demographics
NPI:1396184818
Name:PSYCHOLOGY AND REHABILITATION SERVICES, P.A.
Entity Type:Organization
Organization Name:PSYCHOLOGY AND REHABILITATION SERVICES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:850-523-4261
Mailing Address - Street 1:3494 WEEMS RD
Mailing Address - Street 2:STE. B-2
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-7503
Mailing Address - Country:US
Mailing Address - Phone:850-523-4261
Mailing Address - Fax:850-523-4214
Practice Address - Street 1:3494 WEEMS RD
Practice Address - Street 2:STE. B-2
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32317-7503
Practice Address - Country:US
Practice Address - Phone:850-523-4261
Practice Address - Fax:850-523-4214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0005988103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty