Healthcare Provider Details

I. General information

NPI: 1649408170
Provider Name (Legal Business Name): CENTER FOR HEALTH, LEARNING AND ACHIEVEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2009
Last Update Date: 03/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1561 S ALAFAYA TRL SUITE 200
ORLANDO FL
32828-8956
US

IV. Provider business mailing address

1561 S ALAFAYA TRL SUITE 200
ORLANDO FL
32828-8956
US

V. Phone/Fax

Practice location:
  • Phone: 407-382-5551
  • Fax:
Mailing address:
  • Phone: 407-382-5551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberFLSS710
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberFLSS7701
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberFLSS710
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberFLSS7701
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberFLSS710
License Number StateFL

VIII. Authorized Official

Name: ALICIA N BRACCIA
Title or Position: PRESIDENT
Credential: MA, CAS, LSP, ABSNP
Phone: 407-382-5551