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General NPI Number Information
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NPI Number | 1366844664
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Entity Type | Organization
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Legal Business Name | ENLIGHTENED THERAPY SOLUTIONS, INC.
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Dates
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Enumeration Date | 09/18/2014
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Last Update Date | 09/18/2014
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Provider Practice Location Address
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Address Line | 6645 VINELAND RD SUITE 250
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City | ORLANDO
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State | FL
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Zip | 32819-7841
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Country | US
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Telephone | 407-363-6779
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Fax | 407-363-6830
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Provider Business Mailing Address
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Address Line | 6645 VINELAND RD SUITE 250
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City | ORLANDO
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State | FL
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Zip | 32819-7841
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Country | US
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Telephone | 407-363-6779
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Fax | 407-363-6830
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR
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Name | MS. KATHY M. LEE
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Credential | LMHC
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Telephone | 321-436-7789
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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 | 18201127865
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License Number State | FL
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