Individual
MS. ANITA LOUISE POOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1403 FOREST DR, SANFORD, FL 32771-4656
(407) 328-7992
Mailing address
PO BOX 950130, LAKE MARY, FL 32795-0130
(407) 328-7992
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1164581633
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164581633
—
FL
Enumeration date
06/03/2008
Last updated
07/18/2008
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