Provider Demographics
NPI:1659183069
Name:JERRI SENDACH PH.D, INC
Entity type:Organization
Organization Name:JERRI SENDACH PH.D, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:SENDACH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:561-418-7882
Mailing Address - Street 1:11805 WATERCREST LN
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-6214
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11805 WATERCREST LN
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-6214
Practice Address - Country:US
Practice Address - Phone:561-418-7882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty