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NPI Code Detail

MEDICARE: MS. PATRICIA ANN DESLAURIERS LMHC

MEDICARE: MS. PATRICIA ANN DESLAURIERS LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH7656FL

General Provider Information

NPI Number : 1487749727
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PATRICIA ANN DESLAURIERS LMHC
Provider Business Mailing Address
First Line : 1600 SARNO RD
Second Line : SUITE 119-K
City : MELBOURNE
State : FL
Zip : 32935-4938
Country : US
Telephone Number : 321-254-9449
Fax Number :
Provider Business Practice Location Address
First Line : 1600 SARNO RD
Second Line : SUITE 119-K
City : MELBOURNE
State : FL
Zip : 32935-4938
Country : US
Telephone Number : 321-254-9449
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 07/08/2007

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