Provider Demographics
NPI:1295017705
Name:COFFEE, BARBARA M (MA LMFT)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:M
Last Name:COFFEE
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 FITZHUGH RD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-3537
Mailing Address - Country:US
Mailing Address - Phone:407-600-1260
Mailing Address - Fax:407-678-7299
Practice Address - Street 1:350 FITZHUGH RD
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-3537
Practice Address - Country:US
Practice Address - Phone:407-600-1260
Practice Address - Fax:407-678-7299
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1009652101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health