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General NPI Number Information
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NPI Number | 1063732204
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Entity Type | Individual
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Provider Name | MICHELLE PATTERSON LMHC
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Gender | Female
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Dates
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Enumeration Date | 06/10/2010
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Last Update Date | 05/05/2011
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Provider Practice Location Address
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Address Line | 112 W NEW YORK AVE STE 210
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City | DELAND
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State | FL
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Zip | 32720-5447
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Country | US
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Telephone | 407-797-5289
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Fax |
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Provider Business Mailing Address
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Address Line | 3245 SARDENIA TER
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City | DELTONA
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State | FL
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Zip | 32738-6935
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Country | US
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Telephone | 407-797-5289
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH7765
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License Number State | FL
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