Provider Demographics
NPI:1285998591
Name:STRITTMAN, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:STRITTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 PEMBROOK DR STE 300
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-6378
Mailing Address - Country:US
Mailing Address - Phone:407-212-1199
Mailing Address - Fax:407-386-7037
Practice Address - Street 1:2771 DAWNER CT
Practice Address - Street 2:
Practice Address - City:MILLIKEN
Practice Address - State:CO
Practice Address - Zip Code:80543-3055
Practice Address - Country:US
Practice Address - Phone:407-212-1199
Practice Address - Fax:407-386-7037
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-13-14960103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst