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General NPI Number Information
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NPI Number | 1003798166
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Entity Type | Organization
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Legal Business Name | PUTTENTIAL, INC
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 1222 WINTER GARDEN VINELAND RD STE 112
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City | WINTER GARDEN
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State | FL
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Zip | 34787-4449
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Country | US
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Telephone | 407-877-0029
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Fax | 407-358-5207
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Provider Business Mailing Address
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Address Line | 1222 WINTER GARDEN VINELAND RD STE 112
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City | WINTER GARDEN
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State | FL
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Zip | 34787-4449
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Country | US
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Telephone | 407-877-0029
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Fax | 407-358-5207
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Authorized Official
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Title or Position | OWNER
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Name | CHARITY LE ANTOINETTE HIGGINS
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Credential |
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Telephone | 954-594-2822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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