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General NPI Number Information
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NPI Number | 1215661202
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Entity Type | Organization
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Legal Business Name | TRUEST SELF ENDEAVORS
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Dates
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Enumeration Date | 07/14/2022
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | 366 E GRAVES AVE STE C
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City | ORANGE CITY
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State | FL
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Zip | 32763-5266
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Country | US
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Telephone | 407-710-9002
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Fax |
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Provider Business Mailing Address
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Address Line | 750 STILL RD
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City | PIERSON
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State | FL
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Zip | 32180-2696
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Country | US
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Telephone | 407-710-9002
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JESSICA LEE SZYMCZYK
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Credential | LMHC
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Telephone | 407-710-9002
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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 |
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License Number State |
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