Provider Demographics
NPI:1336440742
Name:RUEDA-BARRERA, ADRIANA ANGELA (MS, NCC LMHC)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:ANGELA
Last Name:RUEDA-BARRERA
Suffix:
Gender:F
Credentials:MS, NCC LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 TREELINE PL
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-7101
Mailing Address - Country:US
Mailing Address - Phone:407-620-0598
Mailing Address - Fax:407-960-3686
Practice Address - Street 1:2500 W LAKE MARY BLVD STE 103
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3501
Practice Address - Country:US
Practice Address - Phone:407-620-0598
Practice Address - Fax:321-926-3048
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-16
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 12023101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health