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General NPI Number Information
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NPI Number | 1184909723
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Entity Type | Individual
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Provider Name | DEBRA MARY LANDES LMHC
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Gender | Female
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Dates
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Enumeration Date | 10/14/2011
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Last Update Date | 10/17/2017
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Provider Practice Location Address
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Address Line | 1210 S FEDERAL HWY STE 201
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-6044
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Country | US
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Telephone | 561-717-9920
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Fax |
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Provider Business Mailing Address
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Address Line | 159 NW 70TH ST APT 613
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City | BOCA RATON
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State | FL
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Zip | 33487-2319
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Country | US
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Telephone | 561-389-3695
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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 | MH4112
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License Number State | FL
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