| Doctor Name: | MS. DEBORAH LYNN BASEDOW |
| NPI Number: | 1134423429 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMHC, NCC |
| License Number: | MH9680 |
| Business Practice Address: | 36739 Sr 52 Suite 213 Dade City, FL - 335255101 |
| Business Phone Number: | 7276981806 |
| Business Fax Number: | |
| Mailing Address: | 2729 Stonewood Dr, LAKELAND |
| State: | FL |
| Postal Code: | 338104015 |
| Phone Number: | 7276981806 |
| Fax Number: | |
| NPI Enumeration Date: | 01/01/2011 |
| NPI Last Update Date: | 01/01/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH9680 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |