Provider Demographics
NPI:1912121211
Name:TODD, DEBORAH D (MA)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:D
Last Name:TODD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3610 N CITRUS CIR
Mailing Address - Street 2:
Mailing Address - City:ZELLWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32798-9715
Mailing Address - Country:US
Mailing Address - Phone:239-850-5908
Mailing Address - Fax:
Practice Address - Street 1:3610 N CITRUS CIR
Practice Address - Street 2:
Practice Address - City:ZELLWOOD
Practice Address - State:FL
Practice Address - Zip Code:32798-9715
Practice Address - Country:US
Practice Address - Phone:239-850-5908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH5402101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health