Individual
ANGELA JERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4700 MILLENIA BLVD, SUITE 175, ORLANDO, FL 32839-6013
(407) 801-8476
Mailing address
10069 LEE VISTA BLVD, APARTMENT 11108, ORLANDO, FL 32829-8117
(813) 444-2784
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
11740
FL
101YM0800X
Mental Health Counselor
Primary
IMH11740
FL
Other
Enumeration date
09/26/2013
Last updated
01/04/2017
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