Provider Demographics
NPI:1679646269
Name:PSYCHOLOGICAL ALLIANCE PL
Entity Type:Organization
Organization Name:PSYCHOLOGICAL ALLIANCE PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:C
Authorized Official - Last Name:HOHNECKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:954-742-7449
Mailing Address - Street 1:4300 N UNIVERSITY DR
Mailing Address - Street 2:C100
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6249
Mailing Address - Country:US
Mailing Address - Phone:954-742-7449
Mailing Address - Fax:954-742-7169
Practice Address - Street 1:4300 N UNIVERSITY DR
Practice Address - Street 2:C100
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6249
Practice Address - Country:US
Practice Address - Phone:954-742-7449
Practice Address - Fax:954-742-7169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5346103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59817Medicare ID - Type Unspecified