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Individual

DEDRIA CORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
711 NW 1ST ST, GAINESVILLE, FL 32601-5343
(813) 395-1527
Mailing address
1485 S SEMORAN BLVD, WINTER PARK, FL 32792-5533

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
01/05/2017
Last updated
01/05/2017
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