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General NPI Number Information
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NPI Number | 1326668971
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Entity Type | Organization
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Legal Business Name | YVEVOLVE LLC
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Dates
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Enumeration Date | 04/23/2020
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Last Update Date | 04/23/2020
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Provider Practice Location Address
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Address Line | 112 PAPRIKA PL
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City | KISSIMMEE
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State | FL
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Zip | 34758-3667
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Country | US
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Telephone | 407-861-6393
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Fax |
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Provider Business Mailing Address
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Address Line | 8297 CHAMPIONS GATE BLVD # 426
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City | CHAMPIONS GATE
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State | FL
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Zip | 33896-8387
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Country | US
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Telephone | 407-861-6393
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Fax |
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Authorized Official
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Title or Position | CEO/MENTAL HEALTH PROFESSIONAL
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Name | YVETTE MOSLEY
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Credential | MSW, LCSW
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Telephone | 857-498-2454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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