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General NPI Number Information
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NPI Number | 1427388479
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Entity Type | Individual
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Provider Name | ANN MAREE WITTOCK-BROWN
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Gender | Female
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Dates
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Enumeration Date | 01/13/2010
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Last Update Date | 01/13/2010
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Provider Practice Location Address
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Address Line | 7410 S US HIGHWAY 1 STE 400
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-1420
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Country | US
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Telephone | 772-340-5750
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Fax |
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Provider Business Mailing Address
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Address Line | 505 CASCADING CREEK LN
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City | WINTER GARDEN
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State | FL
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Zip | 34787-5917
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Country | US
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Telephone | 407-715-4705
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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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