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Individual

DR. PAULA DEFOREST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
2020 COMMERCE DR, WEST MELBOURNE, FL 32904-2335
(321) 952-6000
Mailing address
2290 ROCKLEDGE DR, ROCKLEDGE, FL 32955-5404
(321) 305-5068

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PY0004766
FL

Other

Enumeration date
12/09/2008
Last updated
09/29/2009
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