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Individual

PHYLLIS PALMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
668 N ORLANDO AVE STE 210, MAITLAND, FL 32751-4459
(407) 215-0095
Mailing address
3615 VALLEYVIEW DR, KISSIMMEE, FL 34746-2896
(660) 229-0449
(407) 261-0523

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
FL
101Y00000X
Counselor
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1710268651
FL
Enumeration date
09/06/2011
Last updated
09/07/2011
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