Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | MH9083 | FL |
N | 103G00000X | Clinical Psychologist | PY8016 | FL |
N | 103TC0700X | Clinical Psychologist | PY8016 | FL |
N | 102L00000X | Psychologist | PY8016 | FL |
N | 103T00000X | Psychologist | PY8016 | FL |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PY8016 | FL |
N | 103G00000X | Clinical Psychologist | PY8016 | FL |
N | 103TC0700X | Clinical Psychologist | PY8016 | FL |
Y | 103TF0200X | Forensic Psychologist | PY8016 | FL |
NPI | 1194949495 |
---|---|
Provider Name | Dr. George Zaky |
First Address | Port Saint Lucie, FL 34983-8731 |
Second Address | Port Saint Lucie, FL 34983-8731 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 17/03/2018 |