Doctor Name: | MS. BETH A DECK |
NPI Number: | 1013261601 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | MH2512 |
Business Practice Address: | 4610 W Fairfield Dr Pensacola, FL - 325064106 |
Business Phone Number: | 8504532772 |
Business Fax Number: | 8504532866 |
Mailing Address: | 4610 W Fairfield Dr, PENSACOLA |
State: | FL |
Postal Code: | 325064106 |
Phone Number: | 8504532772 |
Fax Number: | 8504532866 |
NPI Enumeration Date: | 11/03/2012 |
NPI Last Update Date: | 11/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH2512 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |