Provider Demographics
NPI:1679743710
Name:WHITNEY GUIDEBECK LEGLER PSY D P A
Entity Type:Organization
Organization Name:WHITNEY GUIDEBECK LEGLER PSY D P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:GUIDEBECK
Authorized Official - Last Name:LEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:772-231-5554
Mailing Address - Street 1:1701 A1A
Mailing Address - Street 2:SUITE 306
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32963-2206
Mailing Address - Country:US
Mailing Address - Phone:772-231-5554
Mailing Address - Fax:772-231-1088
Practice Address - Street 1:1701 A1A
Practice Address - Street 2:SUITE 306
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32963-2206
Practice Address - Country:US
Practice Address - Phone:772-231-5554
Practice Address - Fax:772-231-1088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6325103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54666Medicare PIN
FL25320Medicare UPIN