Individual
BRIANNA DESOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1217 HUFFSTETLER DR, EUSTIS, FL 32726-8225
(352) 483-1652
Mailing address
PO BOX 491000, LEESBURG, FL 34749-1000
(352) 315-7500
(352) 315-7587
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH16967
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102544400
—
FL
Enumeration date
07/09/2016
Last updated
05/22/2019
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