Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | MH18815 | FL |
N | 225C00000X | Rehabilitation Counselor | 00366590 | FL |
NPI | 1205399698 |
---|---|
Provider Name | Griselle Feisthammel |
First Address | Sarasota, FL 34239-7299 |
Second Address | Sarasota, FL 34239-7299 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2019 |
Last Update Date | 29/01/2021 |