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General NPI Number Information
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NPI Number | 1922672351
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Entity Type | Organization
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Legal Business Name | CREATING BALANCE INC
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Dates
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Enumeration Date | 05/19/2021
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Last Update Date | 05/19/2021
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Provider Practice Location Address
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Address Line | 1800 PEMBROOK DR STE 300
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City | ORLANDO
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State | FL
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Zip | 32810-6378
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Country | US
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Telephone | 954-842-1641
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Fax |
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Provider Business Mailing Address
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Address Line | 677 ERROL PARKWAY
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City | APOPKA
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State | FL
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Zip | 32712
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Country | US
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Telephone | 954-842-1641
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE MULLIGAN
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Credential |
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Telephone | 954-842-1641
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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