Provider Demographics
NPI:1851470504
Name:ABRAMS, PENNY MICHELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:PENNY
Middle Name:MICHELLE
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33429-0457
Mailing Address - Country:US
Mailing Address - Phone:713-906-9057
Mailing Address - Fax:623-236-9484
Practice Address - Street 1:550 SE MIZNER BLVD APT B206
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5581
Practice Address - Country:US
Practice Address - Phone:713-906-9057
Practice Address - Fax:623-236-9484
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31110103TC0700X
CA20753103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX57LVOtherBLUE CROSS BLUE SHIELD