Provider Demographics
NPI:1790300994
Name:DRIZIN, DEBORAH LEAH (LMHC, LMFT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LEAH
Last Name:DRIZIN
Suffix:
Gender:F
Credentials:LMHC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3580 MYSTIC POINTE DR # 106
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2554
Mailing Address - Country:US
Mailing Address - Phone:786-309-1865
Mailing Address - Fax:
Practice Address - Street 1:3580 MYSTIC POINTE DR # 106
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2554
Practice Address - Country:US
Practice Address - Phone:786-309-1865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-12
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3681106H00000X
FL16866101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist