Provider Demographics
NPI:1093099970
Name:DINUZZO, THERESA MARIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:MARIA
Last Name:DINUZZO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13400 SUTTON PARK DR S
Mailing Address - Street 2:SUITE 1504
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-0236
Mailing Address - Country:US
Mailing Address - Phone:904-386-3844
Mailing Address - Fax:
Practice Address - Street 1:13400 SUTTON PARK DR S
Practice Address - Street 2:SUITE 1504
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-0236
Practice Address - Country:US
Practice Address - Phone:904-386-3844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 5891103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist