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Individual

CHANEL FOLSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2725 JUDGE FRAN JAMIESON WAY, VIERA, FL 32940-6605
(321) 690-6459
Mailing address
2575 N COURTENAY PKWY, MERRITT ISLAND, FL 32953-4126
(321) 454-7148

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
03/12/2013
Last updated
03/12/2013
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