Organization
ENLOE BRUCE BILLINGSLEY LCSW PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENLOE BRUCE BILLINGSLEY LCSW (LCSW)
(813) 654-8916
Entity
Organization
Contact information
Practice address
1210 MILLENNIUM PKWY, SUITE 1030, BRANDON, FL 33511-4896
(813) 654-8916
(813) 654-6952
Mailing address
1210 MILLENNIUM PARKWAY, SUITE 1030, BRANDON, FL 33511-4858
(813) 654-8916
(813) 654-6952
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
SW0000194
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z1594
BC/BS
FL
Enumeration date
09/19/2012
Last updated
09/19/2012
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