Provider Demographics
NPI:1891918520
Name:DALIA, JEFFREY MEAD (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MEAD
Last Name:DALIA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 LOST BRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4471
Mailing Address - Country:US
Mailing Address - Phone:561-308-4300
Mailing Address - Fax:
Practice Address - Street 1:205 N DIXIE HWY STE 4.1100
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-4522
Practice Address - Country:US
Practice Address - Phone:561-355-4005
Practice Address - Fax:561-355-4004
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6473103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic