| Tina Dicicco Reynolds, Pa | |
|
11401 Nw 14th Ct Pembroke Pines FL 33026 | |
| (954) 787-9711 | |
| (954) 787-8116 |
| Full Name | Tina Dicicco Reynolds, Pa |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 11401 Nw 14th Ct, Pembroke Pines, Florida |
| Authorized Official Name and Position | Tina Dicicco Reynolds (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 9547879711 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tina Dicicco Reynolds, Pa 11401 Nw 14th Ct Pembroke Pines FL 33026-2505 Ph: (954) 249-1871 | Tina Dicicco Reynolds, Pa 11401 Nw 14th Ct Pembroke Pines FL 33026 Ph: (954) 787-9711 |
| NPI Number | 1336421718 |
|---|---|
| Provider Enumeration Date | 09/12/2011 |
| Last Update Date | 05/06/2021 |
| Certification Date | 04/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336421718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PY 7384 (Florida) | Primary |
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