MEDICARE: DR. DIANE MURRAY PH.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH13364	FL

General Provider Information

NPI Number	:	1982697348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANE MURRAY PH.D

Provider Business Mailing Address
First Line	:	1850 LEE RD
Second Line	:	SUITE 300
City	:	WINTER PARK
State	:	FL
Zip	:	32789-2115
Country	:	US
Telephone Number	:	407-740-8899
Fax Number	:	407-740-8771

Provider Business Practice Location Address
First Line	:	1850 LEE RD
Second Line	:	SUITE 300
City	:	WINTER PARK
State	:	FL
Zip	:	32789-2115
Country	:	US
Telephone Number	:	407-740-8899
Fax Number	:	407-740-8771

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	05/28/2015

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