MEDICARE: ALLISON EUTIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC018273	PA
2	101YM0800X	Mental Health Counselor	24637	FL
3	101YM0800X	Mental Health Counselor	IMH23586	FL

General Provider Information

NPI Number	:	1649090580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON EUTIN

Provider Business Mailing Address
First Line	:	954 LAKE BALDWIN LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32814-6651
Country	:	US
Telephone Number	:	814-701-1145
Fax Number	:

Provider Business Practice Location Address
First Line	:	954 LAKE BALDWIN LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32814-6651
Country	:	US
Telephone Number	:	814-701-1145
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2024
Last Update Date	:	03/03/2026

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Directions to “ ALLISON EUTIN ” Practice Location

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