Provider Demographics
NPI:1841537933
Name:DILLINGHAM, BRENDA (LMFT)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:DILLINGHAM
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:
Other - Last Name:DILLINGHAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:1265 KASS CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-4308
Mailing Address - Country:US
Mailing Address - Phone:352-334-0955
Mailing Address - Fax:352-686-9394
Practice Address - Street 1:1265 KASS CIRCLE
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-8158
Practice Address - Country:US
Practice Address - Phone:352-334-0955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist