Provider Demographics
NPI:1053498634
Name:STEVENS, DAVID BRIAN
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BRIAN
Last Name:STEVENS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2462 CLIFFDALE STREET
Mailing Address - Street 2:DAVID B STEVENS MS LWFT LLC
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761
Mailing Address - Country:US
Mailing Address - Phone:407-905-0508
Mailing Address - Fax:407-656-0020
Practice Address - Street 1:2101 PARK CENTER DRIVE SUITE 270
Practice Address - Street 2:ASSOCIATES IN PSYCHOLOGY & COUNSELING
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835
Practice Address - Country:US
Practice Address - Phone:407-523-1213
Practice Address - Fax:407-523-2398
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1730106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist