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General NPI Number Information
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NPI Number | 1225559933
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Entity Type | Organization
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Legal Business Name | JOY ELANA BREINER
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 5445 VILLAGE DR
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City | VIERA
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State | FL
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Zip | 32955-6430
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Country | US
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Telephone | 321-204-2048
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Fax |
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Provider Business Mailing Address
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Address Line | 5445 VILLAGE DR
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City | VIERA
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State | FL
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Zip | 32955-6430
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LMFT
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Name | JOY ELANA BREINER
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Credential |
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Telephone | 321-204-2048
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT3205
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License Number State | FL
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