David Edwin Roddenberry
David Edwin Roddenberry is a Mental Health Counselor in Saint Augustine, Florida. Practices as a sole proprietor. Licensed in Florida.
- Licensed in
- FL
- In the registry since
- 2025
Practice location Address checks out
109 Nature Walk Pkwy Unit 104Saint Augustine, FL 32092-5065
Phone: (407) 748-0982
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Specialties & licences
| Mental Health Counselor (primary) | Taxonomy 101YM0800X · Licence MH25268 (FL) |
|---|
Record details
| NPI number | 1962217489 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | February 11, 2025 |
| Last updated in NPPES | March 4, 2025 |
| Certification date | March 4, 2025 |
| Mailing address | 24 Seahill Dr, Saint Augustine, FL 32092-1112 |
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