Provider Demographics
NPI:1437363041
Name:ROYCE, DANA QUIST (PHD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:QUIST
Last Name:ROYCE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2967 BEE RIDGE RD
Mailing Address - Street 2:STE 2
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-7113
Mailing Address - Country:US
Mailing Address - Phone:941-922-6203
Mailing Address - Fax:860-652-8711
Practice Address - Street 1:2967 BEE RIDGE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-7113
Practice Address - Country:US
Practice Address - Phone:941-295-7724
Practice Address - Fax:941-960-1807
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7094103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8333AMedicare PIN