Individual
ANNELISE DANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IMH19801
Contact information
Practice address
2700 WESTHALL LN STE 207, MAITLAND, FL 32751-7478
(800) 840-2528
Mailing address
507 SCENIC ST, LEESBURG, FL 34748-6222
(352) 551-4799
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IMH19801
FL
Other
Enumeration date
01/29/2021
Last updated
01/29/2021
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