Provider Demographics
NPI:1023373578
Name:DTT COACHING SERVICES,LLC
Entity Type:Organization
Organization Name:DTT COACHING SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DAMARYS
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMENT
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:305-316-3788
Mailing Address - Street 1:9745 SW 184TH ST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6932
Mailing Address - Country:US
Mailing Address - Phone:786-701-2401
Mailing Address - Fax:305-397-1287
Practice Address - Street 1:9745 SW 184TH ST
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-6932
Practice Address - Country:US
Practice Address - Phone:786-701-2401
Practice Address - Fax:305-397-1287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-11
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health