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General NPI Number Information
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NPI Number | 1629516398
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Entity Type | Organization
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Legal Business Name | A NEW PATH IN CHRISTIAN COUSELING,INC
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 1140 S SEMORAN BLVD STE C
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City | ORLANDO
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State | FL
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Zip | 32807-1459
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Country | US
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Telephone | 407-271-8990
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Fax |
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Provider Business Mailing Address
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Address Line | 1140 S SEMORAN BLVD STE C
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City | ORLANDO
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State | FL
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Zip | 32807-1459
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Country | US
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Telephone | 407-271-8990
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. YOLANDA I JOHNSON
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Credential |
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Telephone | 407-271-8990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2683822
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License Number State | FL
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