Provider Demographics
NPI:1326354606
Name:LABRADOR, MERLYN (MS)
Entity Type:Individual
Prefix:
First Name:MERLYN
Middle Name:
Last Name:LABRADOR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 LAS PALMOS DR SW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32908-1120
Mailing Address - Country:US
Mailing Address - Phone:305-454-3668
Mailing Address - Fax:321-821-0419
Practice Address - Street 1:1500 LAS PALMOS DR SW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32908-1120
Practice Address - Country:US
Practice Address - Phone:305-454-3668
Practice Address - Fax:321-821-0419
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist