Provider Demographics
NPI:1811404452
Name:CARVALHO, DEBBIE CAMILLE
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:CAMILLE
Last Name:CARVALHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:D. CAMILLE
Other - Middle Name:
Other - Last Name:CARVALHO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSED, PD
Mailing Address - Street 1:P.O. BOX 420015
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34742
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4449 GREAT HABOR LANE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34746
Practice Address - Country:US
Practice Address - Phone:347-697-5161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool