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NPI 1609020767

NPI 1609020767 : YOLANDA BRAILEY M.A., L.M.H.C., NCC : ORLANDO, FL

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General NPI Number Information
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    NPI Number           |    1609020767
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    Entity Type          |    Individual 
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    Provider Name        |    YOLANDA BRAILEY M.A., L.M.H.C., NCC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/15/2008
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    Last Update Date     |    06/16/2010
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Provider Practice Location Address
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    Address Line         |    6200 METROWEST BLVD SUITE 201-H
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    City                 |    ORLANDO
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    State                |    FL
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    Zip                  |    32835-7636
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    Country              |    US
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    Telephone            |    407-620-7855
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 341 
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    City                 |    GOTHA
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    State                |    FL
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    Zip                  |    34734-0341
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    Country              |    US
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    Telephone            |    407-620-7855
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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        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    MH 9639
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    License Number State |    FL
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