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2750 Taylor Ave Orlando FL 32806-4474 | |
| (407) 855-4028 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2750 Taylor Ave, Orlando, Florida |
| Authorized Official Name and Position | Cathie Rising-clarke (OWNER) |
| Authorized Official Contact | 4078554028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 560278 Orlando FL 32856-0278 Ph: (407) 855-4028 | 2750 Taylor Ave Orlando FL 32806-4474 Ph: (407) 855-4028 |
| NPI Number | 1205246527 |
|---|---|
| Provider Enumeration Date | 05/08/2014 |
| Last Update Date | 05/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205246527 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | MH000200 (Florida) | Primary |
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