Provider Demographics
NPI:1861689374
Name:LEIFER, MARYANN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARYANN
Middle Name:
Last Name:LEIFER
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 1:8190 JOG RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437
Mailing Address - Country:US
Mailing Address - Phone:561-738-0993
Mailing Address - Fax:561-734-7243
Practice Address - Street 1:8190 JOG RD
Practice Address - Street 2:SUITE 220
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437
Practice Address - Country:US
Practice Address - Phone:561-738-0993
Practice Address - Fax:561-734-7243
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4159103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical