Provider Demographics
NPI:1144360496
Name:PAOLINI, HERDLEY O (PHD)
Entity type:Individual
Prefix:DR
First Name:HERDLEY
Middle Name:O
Last Name:PAOLINI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 CREST CT
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-8108
Mailing Address - Country:US
Mailing Address - Phone:407-461-7664
Mailing Address - Fax:
Practice Address - Street 1:615 E PRINCETON ST
Practice Address - Street 2:SUITE 410
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1456
Practice Address - Country:US
Practice Address - Phone:407-303-9674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6978103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical