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3483 W Vine St Kissimmee FL 34741-4668 | |
| (407) 928-0444 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 3483 W Vine St, Kissimmee, Florida |
| Authorized Official Name and Position | Lynnette Ruiz (THERAPIST) |
| Authorized Official Contact | 4073645016 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
522 Villa Del Sol Cir Apt 203 Orlando FL 32824-9465 Ph: (407) 364-5016 | 3483 W Vine St Kissimmee FL 34741-4668 Ph: (407) 928-0444 |
| NPI Number | 1407349111 |
|---|---|
| Provider Enumeration Date | 06/08/2018 |
| Last Update Date | 06/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407349111 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (Florida) | Primary |
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