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Organization
VISTA PSYCHOLOGICAL SERVICES, PA
Active
Organization
VISTA PSYCHOLOGICAL SERVICES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHERINE W GIBSON MA (V PRES)
(407) 657-5800
Entity
Organization
Contact information
Practice address
120 UNIVERSITY PARK DR, SUITE 215, WINTER PARK, FL 32792-4440
(407) 657-5800
(407) 657-4269
Mailing address
PO BOX 4728, WINTER PARK, FL 32793-4728
(407) 657-5800
(407) 657-4269
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH1561
FL
101YM0800X
Mental Health Counselor
MH3101
FL
Other
Enumeration date
12/28/2006
Last updated
08/22/2020
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