Provider Demographics
NPI:1275942211
Name:AUTUMN FRENCH, LLC.
Entity Type:Organization
Organization Name:AUTUMN FRENCH, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AUTUMN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:386-214-5143
Mailing Address - Street 1:1025 W NEW YORK AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-5184
Mailing Address - Country:US
Mailing Address - Phone:366-214-5143
Mailing Address - Fax:386-873-7565
Practice Address - Street 1:1025 W NEW YORK AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-5184
Practice Address - Country:US
Practice Address - Phone:366-214-5143
Practice Address - Fax:386-873-7565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-04
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 2594106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty