Provider Demographics
NPI:1871834754
Name:PERSAUD TELLINI, SANDRA ANGELA (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:ANGELA
Last Name:PERSAUD TELLINI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2290 S VOLUSIA AVE
Mailing Address - Street 2:STE G
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-7649
Mailing Address - Country:US
Mailing Address - Phone:386-320-3370
Mailing Address - Fax:386-532-0345
Practice Address - Street 1:2290 S VOLUSIA AVE
Practice Address - Street 2:STE G
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-7649
Practice Address - Country:US
Practice Address - Phone:386-320-3370
Practice Address - Fax:386-532-0345
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-02
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLMH13663101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health