Organization
CATALYST FOR CHANGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMIA HUSNI PHD (OWNER REGISTERED AGEWNT)
(407) 968-6723
Entity
Organization
Contact information
Practice address
2101 PARK CENTER DRIVE, SUITE 270, ORLANDO, FL 32835
(407) 523-1213
(407) 523-2398
Mailing address
4114 SHADE TREE LOOP, STE 90, ORLANDO, FL 32810
(407) 968-6723
(407) 294-4332
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY5826
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21491
BCBS GROUP
FL
01
—
51415
BCBS
FL
Enumeration date
11/01/2006
Last updated
08/22/2020
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