Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | MH12417 | FL |
Y | 101YM0800X | Mental Health Counselor | MH12417 | FL |
NPI | 1003340902 |
---|---|
Provider Name | Nicole Silverio |
First Address | Orlando, FL 32827-7589 |
Second Address | Orlando, FL 32827-7589 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2017 |
Last Update Date | 18/04/2017 |