Individual
DR. DARLENE BARRETT ANTONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2700 WESTHALL LN, SUITE 110, MAITLAND, FL 32751-7203
(407) 475-1025
(407) 475-1027
Mailing address
2700 WESTHALL LN, SUITE 110, MAITLAND, FL 32751-7203
(407) 475-1025
(407) 475-1027
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY 4189
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73763X
MEDICARE PTAN
FL
Enumeration date
04/12/2006
Last updated
08/07/2007
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