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General NPI Number Information
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NPI Number | 1164607784
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Entity Type | Organization
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Legal Business Name | THE HEALING TREE
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Dates
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Enumeration Date | 01/02/2008
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 601 W MICHIGAN ST
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City | ORLANDO
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State | FL
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Zip | 32805-6203
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Country | US
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Telephone | 407-317-7430
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Fax | 407-540-1924
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Provider Business Mailing Address
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Address Line | 601 W MICHIGAN ST
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City | ORLANDO
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State | FL
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Zip | 32805-6203
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Country | US
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Telephone | 407-317-7430
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Fax | 407-540-1924
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Authorized Official
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Title or Position | CLINICAL MANAGER
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Name | MRS. ANDREA GARWOOD
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Credential | LMHC
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Telephone | 407-317-7430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | IMH 5299
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License Number State | FL
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