Provider Demographics
NPI:1780056226
Name:ABDULLAH, NINA JUNAINA (MA)
Entity type:Individual
Prefix:MISS
First Name:NINA
Middle Name:JUNAINA
Last Name:ABDULLAH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:JUNAINA
Other - Middle Name:
Other - Last Name:ALBATATI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:19618 STARRY ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32833-5720
Mailing Address - Country:US
Mailing Address - Phone:386-693-6710
Mailing Address - Fax:
Practice Address - Street 1:201 W PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-2753
Practice Address - Country:US
Practice Address - Phone:386-402-5169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMT 2210106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist