Doctor Name: | AMBER LEE DAVELINE |
NPI Number: | 1013106749 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | MH9223 |
Business Practice Address: | 704 Gerneration Point Kissimmee, FL - 34744 |
Business Phone Number: | 4075186936 |
Business Fax Number: | 4075181289 |
Mailing Address: | 601 W. Michigan St. Mp 347, ORLANDO |
State: | FL |
Postal Code: | 32805 |
Phone Number: | 4075186936 |
Fax Number: | 4075181289 |
NPI Enumeration Date: | 10/18/2007 |
NPI Last Update Date: | 09/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | MH9223 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |