Individual
MS. BARBARA DEFAZZIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
503 N PINE MEADOW DR, DEBARY, FL 32713-2365
(386) 473-4566
Mailing address
503 N PINE MEADOW DR, DEBARY, FL 32713-2365
(386) 473-4566
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC6336
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
760556100
—
FL
Enumeration date
04/02/2009
Last updated
04/02/2009
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