Provider Demographics
NPI:1710283957
Name:PREFERRED EDUCATIONAL & PSYCHOLOGICAL SERVICES, INC
Entity Type:Organization
Organization Name:PREFERRED EDUCATIONAL & PSYCHOLOGICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:SPINA
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:786-236-7795
Mailing Address - Street 1:610 SW 34TH ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33315-3623
Mailing Address - Country:US
Mailing Address - Phone:786-236-7795
Mailing Address - Fax:
Practice Address - Street 1:610 SW 34TH ST
Practice Address - Street 2:SUITE 301
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33315-3623
Practice Address - Country:US
Practice Address - Phone:786-236-7795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-06
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7765103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty