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General NPI Number Information
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NPI Number | 1104570134
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Entity Type | Individual
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Provider Name | LORRAINE VILLAR MS MENTAL HEALTH COU
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Gender | Female
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Dates
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Enumeration Date | 02/08/2022
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Last Update Date | 02/08/2022
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Provider Practice Location Address
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Address Line | 1516 E COLONIAL DR STE 101
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City | ORLANDO
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State | FL
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Zip | 32803-4726
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Country | US
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Telephone | 407-701-7723
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Fax | 407-894-1780
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Provider Business Mailing Address
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Address Line | 3508 SANCTUARY DR
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City | SAINT CLOUD
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State | FL
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Zip | 34769-7123
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Country | US
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Telephone | 631-294-6231
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH22048
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License Number State | FL
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