Individual
CHANLLYCA CHAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
3544 EDGEWATER DR, ORLANDO, FL 32804-2922
(407) 291-8009
Mailing address
5512 GARDEN GROVE CIR, WINTER PARK, FL 32792-7362
(904) 860-4074
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1918
ANNIVERSARIES
—
Enumeration date
01/21/2022
Last updated
05/31/2023
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