Provider Demographics
NPI:1710176904
Name:DD PSYCHOLOGY INC
Entity Type:Organization
Organization Name:DD PSYCHOLOGY INC
Other - Org Name:HELP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DUFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:954-551-5678
Mailing Address - Street 1:12994 SPRING LAKE DR
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33330-2749
Mailing Address - Country:US
Mailing Address - Phone:954-551-5678
Mailing Address - Fax:
Practice Address - Street 1:9720 STIRLING RD
Practice Address - Street 2:# 107
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-8013
Practice Address - Country:US
Practice Address - Phone:954-551-5678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6676103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty