Organization
BRUCE L. STAFFORD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE L. STAFFORD LCSW (LILCENSED CLINICAL SOCAIL WORKER)
(407) 648-9118
Entity
Organization
Contact information
Practice address
631 N HYER AVE, ORLANDO, FL 32803-4629
(407) 648-9118
(407) 865-5432
Mailing address
631 N HYER AVE, ORLANDO, FL 32803-4629
(407) 648-9118
(407) 865-5432
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW1618
FL
Other
Enumeration date
05/04/2012
Last updated
05/04/2012
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