Provider Demographics
NPI:1609920081
Name:PATTILLO, DEBORAH R (LMFT)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:R
Last Name:PATTILLO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 NE 25TH AVE
Mailing Address - Street 2:SUITE #504
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-5675
Mailing Address - Country:US
Mailing Address - Phone:352-351-2889
Mailing Address - Fax:
Practice Address - Street 1:1111 NE 25TH AVE
Practice Address - Street 2:SUITE #504
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-5675
Practice Address - Country:US
Practice Address - Phone:352-351-2889
Practice Address - Fax:352-351-9495
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMFT#2145106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist