Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | ||
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1528410909 |
---|---|
Provider Name | Mrs. Charlene Fleurenna |
First Address | Kissimmee, FL 34758-3611 |
Second Address | Kissimmee, FL 34758-3611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2016 |
Last Update Date | 08/07/2016 |