Provider Demographics
NPI:1932352093
Name:GUPTA HOSSAIN, HENAH (PHD)
Entity Type:Individual
Prefix:DR
First Name:HENAH
Middle Name:
Last Name:GUPTA HOSSAIN
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 1:2200 NW CORPORATE BLVD
Mailing Address - Street 2:SUITE 312
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7387
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2200 NW CORPORATE BLVD
Practice Address - Street 2:SUITE 312
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7387
Practice Address - Country:US
Practice Address - Phone:561-283-0206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-02
Last Update Date:2008-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7720103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist