Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | PY 7029 | FL |
N | 103G00000X | Clinical Psychologist | PY 7029 | FL |
N | 103TC0700X | Clinical Psychologist | PY 7029 | FL |
NPI | 1053524314 |
---|---|
Provider Name | Dr. Deborah Lee Radzwill |
First Address | Boca Raton, FL 33433-5562 |
Second Address | Fort Lauderdale, FL 33301-3100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 08/07/2007 |