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General NPI Number Information
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NPI Number | 1457626616
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Entity Type | Organization
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Legal Business Name | CENTER FOR RELATIONSHIP DEVELOPMENT INC
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Dates
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Enumeration Date | 03/20/2012
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Last Update Date | 01/23/2024
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Provider Practice Location Address
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Address Line | 2802 ALOMA AVE STE 102
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City | WINTER PARK
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State | FL
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Zip | 32792-3532
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Country | US
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Telephone | 407-415-0206
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Fax | 407-628-3300
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Provider Business Mailing Address
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Address Line | 2802 ALOMA AVE STE. 102
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City | WINTER PARK
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State | FL
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Zip | 32792-3532
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Country | US
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Telephone | 407-415-0206
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Fax | 407-628-3300
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. SUSAN ELIZABETH SHEPPARD
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Credential | LMHC
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Telephone | 407-415-0206
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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 | MH 3806
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License Number State | FL
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