INDIVIDUAL PROVIDER

LONGWOOD, FL
NPI1033587795
Entity TypeOrganization
Authorized ContactCHRISTINE MARIE GARRY
Master's Level Contract Clinician
317-697-8932
Organization Subpart ?No
Primary Taxonomy251S00000X Community/Behavioral Health
(Licence: FL  ISW10093)
Enumeration Date2015-09-10
Last Update Date2015-09-10
Business Address
INDIVIDUAL PROVIDER
650 PALERMO VISTA CT
LONGWOOD, FL 32750-3419
Phone number: 317-697-8932
Mailing Address
INDIVIDUAL PROVIDER
650 PALERMO VISTA CT
LONGWOOD, FL 32750-3419
Phone number: 317-697-8932