Deller, Cletus Leon

Deller, Cletus Leon is an sole proprietor health care provider with primary practice located at 96173 Piney Island Dr , Fernandina Beach FL 32034-0858. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Deller, Cletus Leon can be contacted via phone (772) 321-3306.

Contact Information

Primary practice address
96173 Piney Island Dr Fernandina Beach FL 32034-0858
Phone: (772) 321-3306
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH10772 Florida

Profile Details

NPI number 1912204470
LBN Legal business name Deller, Cletus Leon
Credentials LMHC INTERN
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 18th, 2011
Last updated Jul 5th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912204470 NPPES
Florida Other MH10772 MENTAL HEALTH LICENSE

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