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General NPI Number Information
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NPI Number | 1407447980
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Entity Type | Organization
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Legal Business Name | DBT ORLANDO
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Dates
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Enumeration Date | 01/28/2021
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 978 DOUGLAS AVE STE 107
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-5205
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Country | US
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Telephone | 321-417-7299
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Fax |
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Provider Business Mailing Address
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Address Line | 711 N ORLANDO AVE STE 203A
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City | MAITLAND
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State | FL
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Zip | 32751-4403
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Country | US
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Telephone | 407-754-6967
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Fax |
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Authorized Official
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Title or Position | COUNSELOR / OWNER
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Name | MARIBEL J RODRIGUEZ
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Credential | LMCH
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Telephone | 407-754-6967
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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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