Provider Demographics
NPI:1699020610
Name:SPECTOR, SHIFRA (PSYD)
Entity Type:Individual
Prefix:
First Name:SHIFRA
Middle Name:
Last Name:SPECTOR
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 1:3549 BENDEMEER RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1953
Mailing Address - Country:US
Mailing Address - Phone:516-639-5441
Mailing Address - Fax:
Practice Address - Street 1:3549 BENDEMEER RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1953
Practice Address - Country:US
Practice Address - Phone:872-216-5138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-16
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08071103T00000X
NY1405792103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool