Provider First Line Business Practice Location Address:
4851 S APOPKA VINELAND RD
Provider Second Line Business Practice Location Address:
BLDG A SUITE # 111 (COMMUNITY COUNSELING CENTER)
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32819-3128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-340-5312
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/23/2008