Healthcare Provider Details

I. General information

NPI: 1912742941
Provider Name (Legal Business Name): PUZZLED LIFE COUNSELING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 07/01/2024
Certification Date: 07/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7216 LAKE WILLIS DR
ORLANDO FL
32821-9317
US

IV. Provider business mailing address

7216 LAKE WILLIS DR
ORLANDO FL
32821-9317
US

V. Phone/Fax

Practice location:
  • Phone: 407-496-7868
  • Fax:
Mailing address:
  • Phone: 407-496-7868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. KIMBERLY DAWN SNOEBLEN
Title or Position: OWNER
Credential: LMHC
Phone: 407-496-7868