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General NPI Number Information
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NPI Number | 1295040319
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Entity Type | Individual
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Provider Name | DENISE LYNN LMHC
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Gender | Female
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Dates
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Enumeration Date | 08/12/2010
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Last Update Date | 08/12/2010
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Provider Practice Location Address
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Address Line | 2723 BELLE HAVEN DR
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City | CLEARWATER
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State | FL
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Zip | 33763-1002
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Country | US
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Telephone | 727-743-2805
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Fax | 727-733-2806
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Provider Business Mailing Address
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Address Line | 1941 SOURWOOD BLVD
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City | DUNEDIN
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State | FL
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Zip | 34698-2951
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Country | US
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Telephone | 727-743-2805
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Fax | 727-733-2806
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | MH1381
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License Number State | FL
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