Individual
AHUVA BAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
18510 MADISON AVE, ORLANDO, FL 32820-2559
(407) 254-9402
Mailing address
116 BEAUFORT DR, LONGWOOD, FL 32779-5701
(407) 682-5306
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/14/2009
Last updated
10/14/2009
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