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General NPI Number Information
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NPI Number | 1295272813
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Entity Type | Organization
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Legal Business Name | SOFOE FAMILY COUNSELING LLC
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Dates
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Enumeration Date | 01/20/2017
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Last Update Date | 01/20/2017
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Provider Practice Location Address
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Address Line | 3011 CURVING OAKS WAY
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City | ORLANDO
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State | FL
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Zip | 32820-2747
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Country | US
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Telephone | 407-630-1396
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Fax |
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Provider Business Mailing Address
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Address Line | 3011 CURVING OAKS WAY
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City | ORLANDO
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State | FL
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Zip | 32820-2747
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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 | OWNER/AUTHORIZED OFFICIAL
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Name | MARLEEN HAMILTON
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Credential | LMHC
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Telephone | 407-630-1396
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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 | 13260
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License Number State | FL
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