Provider Demographics
NPI:1194992164
Name:LASALLE-RICCI, VERONICA HOLLAND (PHD)
Entity type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:HOLLAND
Last Name:LASALLE-RICCI
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 1:441 JUNO DUNES WAY
Mailing Address - Street 2:
Mailing Address - City:JUNO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-2307
Mailing Address - Country:US
Mailing Address - Phone:561-234-7883
Mailing Address - Fax:
Practice Address - Street 1:11903 SOUTHERN BLVD STE 104
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-7644
Practice Address - Country:US
Practice Address - Phone:561-333-8884
Practice Address - Fax:561-333-2122
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 7719103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist