Organization
SUNDANCE RANCH CHRISTIAN CHURCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY LYNN WHARTON PHD (EXECUTIVE DIRECTOR)
(321) 305-5946
Entity
Organization
Contact information
Practice address
390 S COURTENAY PKWY, MERRITT ISLAND, FL 32952-4847
(321) 305-5946
Mailing address
1900 PINE ISLAND RD, MERRITT ISLAND, FL 32953-6517
(215) 559-1184
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
204811419
FL
Other
Enumeration date
01/14/2015
Last updated
01/14/2015
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