Organization
PAULA DEFOREST PHD LLC
Active
Other names
Paula DeForest PhD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAULA DEFOREST (PSYCHOLOGIST)
(321) 305-5068
Entity
Organization
Contact information
Practice address
1425 AURORA RD, MELBOURNE, FL 32935-5315
(321) 242-3110
Mailing address
2290 ROCKLEDGE DR, ROCKLEDGE, FL 32955-5404
(321) 305-5068
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PY0004766
FL
103TB0200X
Cognitive & Behavioral Psychologist
PY0004766
FL
103TC0700X
Clinical Psychologist
PY0004766
FL
103TC1900X
Counseling Psychologist
PY0004766
FL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PY0004766
FL
103TF0000X
Family Psychologist
PY0004766
FL
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PY0004766
FL
103TS0200X
School Psychologist
PY0004766
FL
Other
Enumeration date
07/24/2015
Last updated
07/24/2015
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