Doctor Name: | MS. JUDA MARIE DECARA |
NPI Number: | 1548513310 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA,NCC,CCMHC |
License Number: | IMH9063 |
Business Practice Address: | 4690 Lipscomb St Se Suite 6c Palm Bay, FL - 32905 |
Business Phone Number: | 8137677884 |
Business Fax Number: | 3215745417 |
Mailing Address: | 994 Sedgewood Cir, MELBOURNE |
State: | FL |
Postal Code: | 329048037 |
Phone Number: | 8137677884 |
Fax Number: | 3215745417 |
NPI Enumeration Date: | 10/18/2012 |
NPI Last Update Date: | 11/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | IMH9063 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
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 |