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Organization
PROVIDENCE ACADEMY, INC
Active
Organization
PROVIDENCE ACADEMY, INC
Active
Other names
Providence Foundation
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICIA NARET BRACCIA MA,CAS,ABSNP, LSP (FOUNDATION PRESIDENT)
(407) 382-5551
Entity
Organization
Contact information
Practice address
1561 S ALAFAYA TRL, SUITE 200, ORLANDO, FL 32828-8956
(407) 382-5551
(407) 382-5637
Mailing address
1561 S ALAFAYA TRL, SUITE 200, ORLANDO, FL 32828-8956
(407) 382-5551
(407) 382-5637
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
—
—
103TS0200X
School Psychologist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001021700
—
FL
Enumeration date
03/16/2012
Last updated
01/08/2013
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