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General NPI Number Information
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NPI Number | 1083254189
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Entity Type | Individual
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Provider Name | IRMELLE IN NORVIL
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Gender | Female
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 101 S DIXIE DR STE 101
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City | HAINES CITY
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State | FL
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Zip | 33844-2844
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Country | US
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Telephone | 863-216-6595
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Fax |
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Provider Business Mailing Address
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Address Line | 539 TIMBERLANE W APT C
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City | LAKELAND
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State | FL
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Zip | 33801-7815
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Country | US
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Telephone | 863-430-2868
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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