Individual
CHRISTA VERMILLERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
937 DIXON BLVD, COCOA, FL 32922-6806
(321) 446-2113
(321) 241-4605
Mailing address
937 DIXON BLVD, COCOA, FL 32922-6806
(321) 446-2113
(321) 241-4605
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
9873
FL
101YM0800X
Mental Health Counselor
Primary
MH 9873
FL
103K00000X
Behavior Analyst
1-21-47877
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-21-47877
103K00000X
FL
05
—
772265
—
FL
Enumeration date
10/07/2008
Last updated
10/16/2024
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