Provider Demographics
NPI:1912253642
Name:GUAGLIARDO, REBECCA HEARD (PSYD)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:HEARD
Last Name:GUAGLIARDO
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 1:3717 TURMAN LOOP STE 101
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7794
Mailing Address - Country:US
Mailing Address - Phone:813-982-4230
Mailing Address - Fax:813-982-4230
Practice Address - Street 1:3717 TURMAN LOOP STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-7794
Practice Address - Country:US
Practice Address - Phone:813-982-4230
Practice Address - Fax:813-982-4230
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101YP2500XMedicaid