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General NPI Number Information
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NPI Number | 1316503022
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Entity Type | Individual
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Provider Name | DEANNA PAUL LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/17/2019
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Last Update Date | 05/17/2019
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Provider Practice Location Address
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Address Line | 24160 STATE ROAD 54 STE 5
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City | LUTZ
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State | FL
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Zip | 33559-6766
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Country | US
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Telephone | 813-365-1344
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Fax |
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Provider Business Mailing Address
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Address Line | 4401 AKITA DR
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City | TAMPA
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State | FL
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Zip | 33624-1103
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Country | US
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Telephone | 813-365-1344
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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 | MH16918
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License Number State | FL
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