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General NPI Number Information
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NPI Number | 1205559648
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Entity Type | Individual
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Provider Name | ALYSSA NEGRON LMHC
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Gender | Female
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Dates
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Enumeration Date | 09/21/2022
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 531 VERSAILLES DR STE 100
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City | MAITLAND
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State | FL
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Zip | 32751-4591
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Country | US
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Telephone | 407-900-9632
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Fax |
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Provider Business Mailing Address
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Address Line | 90 CHANEY DR
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City | CASSELBERRY
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State | FL
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Zip | 32707-4533
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Country | US
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Telephone | 407-900-9632
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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 | MH21093
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License Number State | FL
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