Doctor Name: | MRS. MELITA COGBURN |
NPI Number: | 1457661787 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | B.S., M.A., LLPC |
License Number: | 2666523 |
Business Practice Address: | 111 Monument Ave Suite 509 Kissimmee, FL - 34746 |
Business Phone Number: | 4079003518 |
Business Fax Number: | 5170000000 |
Mailing Address: | 3161 Winding Trail, KISSIMMEE |
State: | FL |
Postal Code: | 34746 |
Phone Number: | 5172903816 |
Fax Number: | 5170000000 |
NPI Enumeration Date: | 10/20/2010 |
NPI Last Update Date: | 12/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 2666523 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |