Healthcare Provider Details

I. General information

NPI: 1922786169
Provider Name (Legal Business Name): CRISLAINY KETY DE ARRUDA SWANER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2023
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 S HIAWASSEE RD STE 114
ORLANDO FL
32835-5706
US

IV. Provider business mailing address

1452 MUIR CIR
CLERMONT FL
34711-6544
US

V. Phone/Fax

Practice location:
  • Phone: 407-840-7828
  • Fax:
Mailing address:
  • Phone: 407-840-7828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: