Provider Demographics
NPI:1881701704
Name:SABRA, LAURIE N (PHD)
Entity type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:N
Last Name:SABRA
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 1:4600 SHERIDAN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3409
Mailing Address - Country:US
Mailing Address - Phone:954-989-3600
Mailing Address - Fax:954-894-1884
Practice Address - Street 1:4600 SHERIDAN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3409
Practice Address - Country:US
Practice Address - Phone:954-989-3600
Practice Address - Fax:954-894-1884
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0004261103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73533Medicare ID - Type Unspecified