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General NPI Number Information
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NPI Number | 1528640497
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Entity Type | Individual
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Provider Name | KATHERINE E DEERY
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Gender | Female
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Dates
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Enumeration Date | 04/21/2021
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Last Update Date | 04/21/2021
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Provider Practice Location Address
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Address Line | 37 N ORANGE AVE STE 1100
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City | ORLANDO
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State | FL
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Zip | 32801-2449
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Country | US
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Telephone | 407-900-8633
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1229
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City | WINDERMERE
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State | FL
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Zip | 34786-1229
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Country | US
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Telephone |
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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 | 1851845523
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License Number State |
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