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General NPI Number Information
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NPI Number | 1679392047
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Entity Type | Individual
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Provider Name | BRANDI NAHRAIN VILLAFUERTE
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Gender | Female
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Dates
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Enumeration Date | 10/03/2024
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 3222 CORRINE DR STE J
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City | ORLANDO
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State | FL
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Zip | 32803-2217
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Country | US
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Telephone | 689-291-3828
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Fax |
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Provider Business Mailing Address
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Address Line | 3222 CORRINE DR STE J
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City | ORLANDO
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State | FL
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Zip | 32803-2217
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Country | US
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Telephone |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMT3911
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH24144
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License Number State | FL
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