Provider Demographics
NPI:1235600263
Name:QUANDT, ALYCE KATHERINE
Entity Type:Individual
Prefix:MS
First Name:ALYCE
Middle Name:KATHERINE
Last Name:QUANDT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2958 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8064
Mailing Address - Country:US
Mailing Address - Phone:407-463-0809
Mailing Address - Fax:
Practice Address - Street 1:225 S SWOOPE AVE STE 211
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5786
Practice Address - Country:US
Practice Address - Phone:407-622-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health