Organization
FRONTIER THERAPY LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW WATSON LMHC (OWNER)
(407) 497-0760
Entity
Organization
Contact information
Practice address
430 N MILLS AVE STE 4, ORLANDO, FL 32803-5746
(407) 423-0790
Mailing address
430 N MILLS AVE STE 4, ORLANDO, FL 32803-5746
(407) 423-0790
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14268544
CAQH
—
Enumeration date
06/13/2018
Last updated
06/13/2018
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