| Doctor Name: | DAVID R LLEWELLYN |
| NPI Number: | 1083917207 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | MH11239 |
| Business Practice Address: | 9180 Estero Park Commons Blvd Suite 6 Estero, FL - 339283218 |
| Business Phone Number: | 2395953022 |
| Business Fax Number: | 2392448404 |
| Mailing Address: | 9180 Estero Park Commons Blvd, Suite 6 ESTERO |
| State: | FL |
| Postal Code: | 339283218 |
| Phone Number: | 2395953022 |
| Fax Number: | 2392448404 |
| NPI Enumeration Date: | 12/09/2010 |
| NPI Last Update Date: | 10/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH11239 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |