Healthcare Provider Details
I. General information
NPI: 1114137304
Provider Name (Legal Business Name): PERSONAL DYNAMICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
711 BALLARD ST
ALTAMONTE SPRINGS FL
32701-5441
US
IV. Provider business mailing address
200 MAITLAND AVE APT 191
ALTAMONTE SPRINGS FL
32701-5551
US
V. Phone/Fax
- Phone: 407-869-1776
- Fax:
- Phone: 407-869-1776
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | MH3513 |
| License Number State | FL |
VIII. Authorized Official
Name: MRS.
MARGARET
S
SEYKORA
Title or Position: PRESIDENT
Credential: LMHC
Phone: 407-869-1776