Provider Demographics
NPI:1174634398
Name:PALTER, DENISE (LCSW)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:PALTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 MILLENNIUM PKWY
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-4896
Mailing Address - Country:US
Mailing Address - Phone:813-684-7340
Mailing Address - Fax:813-684-6887
Practice Address - Street 1:1210 MILLENNIUM PKWY
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4896
Practice Address - Country:US
Practice Address - Phone:813-684-7340
Practice Address - Fax:813-684-6887
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW29621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical