Provider Demographics
NPI:1225278104
Name:LABROT, PATRICIA (M,ED, NCSP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:LABROT
Suffix:
Gender:F
Credentials:M,ED, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 ARDEN ST
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-6324
Mailing Address - Country:US
Mailing Address - Phone:407-767-8569
Mailing Address - Fax:
Practice Address - Street 1:237 LOOKOUT PL STE 150
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-8431
Practice Address - Country:US
Practice Address - Phone:407-462-1323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS409103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool