Provider Demographics
NPI:1528281243
Name:DELGIUDICE, CONSTANCE ANN (LMCH)
Entity type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:ANN
Last Name:DELGIUDICE
Suffix:
Gender:F
Credentials:LMCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3457 SW PINDO PALM LN
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-3161
Mailing Address - Country:US
Mailing Address - Phone:772-781-0906
Mailing Address - Fax:
Practice Address - Street 1:4001 NE SAVANNAH RD
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-3805
Practice Address - Country:US
Practice Address - Phone:772-631-6138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 9049101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health