Individual
ALEAH LODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1540 INTERNATIONAL PKWY STE 255, LAKE MARY, FL 32746-5096
(407) 603-5636
Mailing address
1540 INTERNATIONAL PKWY STE 255, LAKE MARY, FL 32746-5096
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH18463
FL
Other
Enumeration date
03/03/2021
Last updated
03/03/2021
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