Healthcare Provider Details

I. General information

NPI: 1063469476
Provider Name (Legal Business Name): DARYL DOWDING LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 ALICIA RD
LAKELAND FL
33801
US

IV. Provider business mailing address

3312 CARSON OAKS LANE
PLANT CITY FL
33565
US

V. Phone/Fax

Practice location:
  • Phone: 863-680-1950
  • Fax: 863-683-4654
Mailing address:
  • Phone: 813-220-8924
  • Fax: 813-301-8313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH005881
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: