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General NPI Number Information
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NPI Number | 1346953692
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Entity Type | Organization
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Legal Business Name | WELCOME TO RESILIENCE
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Dates
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Enumeration Date | 01/02/2023
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Last Update Date | 05/14/2023
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Provider Practice Location Address
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Address Line | 111 JEWEL DR
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32714-2715
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Country | US
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Telephone | 863-330-0535
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Fax | 863-877-4682
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Provider Business Mailing Address
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Address Line | 113 SILVER MAPLE BND
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City | DAVENPORT
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State | FL
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Zip | 33837-9533
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Country | US
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Telephone | 863-330-0535
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Fax | 863-877-4682
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | MRS. KENISHA BRASWELL
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Credential | LCSW
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Telephone | 863-330-0535
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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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