Provider Demographics
NPI:1922218460
Name:ANGLIN, DENISIA MARIE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:DENISIA
Middle Name:MARIE
Last Name:ANGLIN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 BEVILLE RD
Mailing Address - Street 2:SUITE 118
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-1967
Mailing Address - Country:US
Mailing Address - Phone:386-761-1327
Mailing Address - Fax:386-788-5021
Practice Address - Street 1:661 BEVILLE RD
Practice Address - Street 2:SUITE 118
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-1967
Practice Address - Country:US
Practice Address - Phone:386-761-1327
Practice Address - Fax:386-788-5021
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2199106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist