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3501 W Vine St Suite 511 Kissimmee FL 34741-4643 | |
| (407) 744-3554 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3501 W Vine St, Kissimmee, Florida |
| Authorized Official Name and Position | Rochelle M Hall (CEO) |
| Authorized Official Contact | 4077443554 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3501 W Vine St Suite 511 Kissimmee FL 34741-4643 Ph: (407) 744-3554 | 3501 W Vine St Suite 511 Kissimmee FL 34741-4643 Ph: (407) 744-3554 |
| NPI Number | 1851707996 |
|---|---|
| Provider Enumeration Date | 07/09/2014 |
| Last Update Date | 07/09/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851707996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW10492 (Florida) | Primary |
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