Provider Demographics
NPI:1811252935
Name:NEDLEY, KATRINA (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:
Last Name:NEDLEY
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7802 CAMERON CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-5661
Mailing Address - Country:US
Mailing Address - Phone:239-826-3887
Mailing Address - Fax:
Practice Address - Street 1:7802 CAMERON CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-5661
Practice Address - Country:US
Practice Address - Phone:239-826-3887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1121106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist