Provider Demographics
NPI:1609405729
Name:MARIA V. NODARSE, PSY. D., INC
Entity Type:Organization
Organization Name:MARIA V. NODARSE, PSY. D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:V
Authorized Official - Last Name:NODARSE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:352-630-0373
Mailing Address - Street 1:3279 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-5410
Mailing Address - Country:US
Mailing Address - Phone:352-321-0098
Mailing Address - Fax:352-385-0128
Practice Address - Street 1:1175 LUCERNE DR
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-3639
Practice Address - Country:US
Practice Address - Phone:352-630-0373
Practice Address - Fax:352-385-0128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-02
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty