Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 224P00000X | Prosthetist |
NPI | 1285292789 |
---|---|
Provider Name | Audrey Perryman |
First Address | Ocoee, FL 34761-7014 |
Second Address | Altamonte Springs, FL 32701-5426 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2019 |
Last Update Date | 31/05/2019 |