Provider Demographics
NPI:1841240124
Name:CHARACTER, COLLEEN D (PHD)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:D
Last Name:CHARACTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 SW 34TH AVE
Mailing Address - Street 2:# 905-167
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-7447
Mailing Address - Country:US
Mailing Address - Phone:352-629-4637
Mailing Address - Fax:352-629-4935
Practice Address - Street 1:2801 SW COLLEGE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7406
Practice Address - Country:US
Practice Address - Phone:352-629-4637
Practice Address - Fax:352-629-4935
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6847103TC0700X
OH5250103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL74070Medicare ID - Type UnspecifiedCLINICAL PSYCHOLOGIST