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General NPI Number Information
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NPI Number | 1275863235
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Entity Type | Organization
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Legal Business Name | FENN SYSTEMS INC.
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Dates
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Enumeration Date | 01/13/2010
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Last Update Date | 01/13/2010
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Provider Practice Location Address
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Address Line | 1870 ALOMA AVE STE 110
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City | WINTER PARK
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State | FL
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Zip | 32789-4050
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Country | US
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Telephone | 407-629-2883
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Fax | 407-629-2883
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Provider Business Mailing Address
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Address Line | 1870 ALOMA AVE STE 110
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City | WINTER PARK
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State | FL
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Zip | 32789-4050
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Country | US
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Telephone | 407-629-2883
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Fax | 407-629-2883
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Authorized Official
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Title or Position | DIRECTOR
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Name | TIMOTHY E FENNELL
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Credential | PHD
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Telephone | 407-629-2883
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW9595
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License Number State | FL
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