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General NPI Number Information
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NPI Number | 1083506133
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Entity Type | Individual
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Provider Name | JODI LEE DRAKE MA, IMH26441, PMH-C
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Gender | Female
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 465 MAITLAND AVE STE 16
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-5444
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Country | US
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Telephone | 321-616-7225
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Fax | 407-598-7797
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Provider Business Mailing Address
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Address Line | 10313 CARLSON CIR
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City | CLERMONT
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State | FL
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Zip | 34711-7885
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Country | US
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Telephone | 765-543-7251
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Fax | 765-543-7251
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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 | IMH26441
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License Number State | FL
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