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General NPI Number Information
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NPI Number | 1396417762
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Entity Type | Organization
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Legal Business Name | CAMELLIA COUNSELING LLC
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Dates
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Enumeration Date | 10/04/2021
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 809C DAPHNE AVE STE 101
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City | DAPHNE
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State | AL
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Zip | 36526-4297
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Country | US
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Telephone | 205-201-1763
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Fax |
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Provider Business Mailing Address
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Address Line | 11667 BURBANK CT
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City | SPANISH FORT
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State | AL
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Zip | 36527-5296
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Country | US
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Telephone | 251-454-1150
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MELISSA A. SMILIE
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Credential | LPC-S
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Telephone | 251-454-1150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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