Organization
SUSAN ADDIS PHD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN ADDIS PHD (PRESIDENT)
(352) 870-5302
Entity
Organization
Contact information
Practice address
10359 ORANGEWOOD BLVD, ORLANDO, FL 32821-8239
(352) 870-5302
Mailing address
12653 ARLEY DR, WINDERMERE, FL 34786-6620
(352) 870-5302
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PY 5626
FL
Other
Enumeration date
12/14/2015
Last updated
12/14/2015
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