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3125 Bruton Blvd Suite A Orlando FL 32805 | |
| (407) 514-4470 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 3125 Bruton Blvd, Orlando, Florida |
| Authorized Official Name and Position | Kari Bozard Russo (DIRECTOR /LICENSED MENTAL HEALTH) |
| Authorized Official Contact | 4075144470 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3125 Bruton Blvd Suite A Orlando FL 32805 Ph: (407) 514-4470 | 3125 Bruton Blvd Suite A Orlando FL 32805 Ph: (407) 514-4470 |
| NPI Number | 1124324934 |
|---|---|
| Provider Enumeration Date | 01/27/2011 |
| Last Update Date | 03/21/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124324934 | NPI | - | NPPES |
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