Provider Demographics
NPI:1447669882
Name:DUDA, PATRICIA (LMHC)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:DUDA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 S LAKE JESSUP AVE
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8726
Mailing Address - Country:US
Mailing Address - Phone:407-739-7348
Mailing Address - Fax:
Practice Address - Street 1:905 S LAKE JESSUP AVE
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8726
Practice Address - Country:US
Practice Address - Phone:407-739-7348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12171101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health