Provider Demographics
NPI:1922340322
Name:MACCLOSKEY, DEANN LYNN (MS)
Entity Type:Individual
Prefix:
First Name:DEANN
Middle Name:LYNN
Last Name:MACCLOSKEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:DEANN
Other - Middle Name:LYNN
Other - Last Name:MCKEEVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3487 WILSHIRE WAY RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32829-7353
Mailing Address - Country:US
Mailing Address - Phone:386-237-0063
Mailing Address - Fax:
Practice Address - Street 1:111 E MONUMENT AVE
Practice Address - Street 2:509
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5762
Practice Address - Country:US
Practice Address - Phone:386-259-5413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-23
Last Update Date:2013-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health