Organization
SUPPORTIVE COUNSELING
Active
Organization
SUPPORTIVE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAWAL SAJIH ABOULHOSN PHD (CHIEF EXECUTIVE OFFICER)
(321) 525-1556
Entity
Organization
Contact information
Practice address
310 E MAIN ST, AVON PARK, FL 33825-3216
(321) 525-1556
Mailing address
310 E MAIN ST, AVON PARK, FL 33825-3216
(321) 525-1556
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
CAP 5229
FL
251S00000X
Community/Behavioral Health Agency
MH 7623
FL
251S00000X
Community/Behavioral Health Agency
Primary
MT 2810
FL
Other
Enumeration date
08/22/2016
Last updated
08/22/2016
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