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General NPI Number Information
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NPI Number | 1508281502
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Entity Type | Individual
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Provider Name | JULIE WYATT MASTERS
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Gender | Female
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Dates
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Enumeration Date | 02/27/2014
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Last Update Date | 11/19/2022
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Provider Practice Location Address
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Address Line | 9024 AVENUE POINTE CIR APT 105
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City | ORLANDO
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State | FL
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Zip | 32821-6361
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Country | US
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Telephone | 774-254-3364
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Fax |
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Provider Business Mailing Address
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Address Line | 9024 AVENUE POINTE CIR APT 105
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City | ORLANDO
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State | FL
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Zip | 32821-6361
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Country | US
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Telephone | 774-254-3364
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | MH18321
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License Number State | FL
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