Provider Demographics
NPI:1053524314
Name:RADZWILL, DEBORAH LEE (PSYD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LEE
Last Name:RADZWILL
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 1:22296 CALIBRE CT
Mailing Address - Street 2:APARTMENT 1502
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5562
Mailing Address - Country:US
Mailing Address - Phone:561-706-2854
Mailing Address - Fax:
Practice Address - Street 1:3119 WATERSIDE CIR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-6403
Practice Address - Country:US
Practice Address - Phone:561-706-2854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7029103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical