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General NPI Number Information
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NPI Number | 1275901407
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Entity Type | Organization
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Legal Business Name | HEALING WITH WISDOM, LLC
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Dates
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Enumeration Date | 09/03/2015
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 3956 TOWN CTR BLVD SUITE 22
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City | ORLANDO
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State | FL
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Zip | 32837-6103
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Country | US
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Telephone | 407-508-4705
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Fax | 407-264-6726
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Provider Business Mailing Address
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Address Line | 3956 TOWN CTR BLVD SUITE 22
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City | ORLANDO
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State | FL
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Zip | 32837-6103
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Country | US
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Telephone | 407-508-4705
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Fax | 407-264-6726
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Authorized Official
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Title or Position | CEO
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Name | KERRI-ANNE BROWN
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Credential | LMHC
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Telephone | 407-508-4705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MH10070
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License Number State | FL
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