Provider Demographics
NPI:1437908050
Name:LEAO DE CAMARGO, ANA PAULA (PSYD)
Entity type:Individual
Prefix:
First Name:ANA PAULA
Middle Name:
Last Name:LEAO DE CAMARGO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 LAGO CIR APT 203
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-3360
Mailing Address - Country:US
Mailing Address - Phone:407-818-3550
Mailing Address - Fax:
Practice Address - Street 1:220 LAGO CIR APT 203
Practice Address - Street 2:
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-3360
Practice Address - Country:US
Practice Address - Phone:407-818-3550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic