Provider Demographics
NPI:1376700740
Name:SEGOTA, MARY-CATHERINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARY-CATHERINE
Middle Name:
Last Name:SEGOTA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13350 W COLONIAL DR
Mailing Address - Street 2:SUITE 340
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-3964
Mailing Address - Country:US
Mailing Address - Phone:407-654-4433
Mailing Address - Fax:407-926-0209
Practice Address - Street 1:13350 W COLONIAL DR
Practice Address - Street 2:SUITE 340
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-3964
Practice Address - Country:US
Practice Address - Phone:407-654-4433
Practice Address - Fax:407-926-0209
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY7123103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical