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General NPI Number Information
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NPI Number | 1083727101
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Entity Type | Organization
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Legal Business Name | WELLNESS INSTITUTE OF ORLANDO
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 851 W SR 436 1089
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714
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Country | US
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Telephone | 407-786-0600
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Fax | 407-786-0650
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Provider Business Mailing Address
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Address Line | 851 W SR 436 1089
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714
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Country | US
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Telephone | 407-786-0600
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Fax | 407-786-0650
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | LINDA D FREEMAN
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Credential | MA
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Telephone | 407-463-7564
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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 | 0748AD391101
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License Number State | FL
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