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General NPI Number Information
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NPI Number | 1215655634
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Entity Type | Individual
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Provider Name | MS. NICOLE C DEAN
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Gender | Female
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 36156 GRESHAM RD
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City | WEBSTER
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State | FL
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Zip | 33597-9287
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Country | US
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Telephone | 813-449-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 5526 SW 113TH PL
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City | WEBSTER
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State | FL
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Zip | 33597-7308
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Country | US
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Telephone | 813-355-1113
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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 |
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License Number State |
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