Individual
BRYCE FOULKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1801 CHARLES CT, SAINT CLOUD, FL 34771-8806
(321) 624-5948
Mailing address
1801 CHARLES CT, SAINT CLOUD, FL 34771-8806
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
IMT 1033
FL
Other
Enumeration date
06/03/2009
Last updated
06/03/2009
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