Provider Demographics
NPI:1629786298
Name:DE LORENZO, DANA
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:DE LORENZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 NW 48TH TER
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2028
Mailing Address - Country:US
Mailing Address - Phone:954-682-1097
Mailing Address - Fax:
Practice Address - Street 1:949 NW 83RD DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7158
Practice Address - Country:US
Practice Address - Phone:954-899-3796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst