| Catalyst For Change Llc | |
|
2101 Park Center Drive Suite 270 Orlando FL 32835 | |
| (407) 523-1213 | |
| (407) 523-2398 |
| Full Name | Catalyst For Change Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2101 Park Center Drive, Orlando, Florida |
| Authorized Official Name and Position | Samia Husni (OWNER REGISTERED AGEWNT) |
| Authorized Official Contact | 4079686723 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Catalyst For Change Llc 4114 Shade Tree Loop Ste 90 Orlando FL 32810 Ph: (407) 968-6723 | Catalyst For Change Llc 2101 Park Center Drive Suite 270 Orlando FL 32835 Ph: (407) 523-1213 |
| NPI Number | 1093892671 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093892671 | NPI | - | NPPES |
| 21491 | Other | FL | BCBS GROUP |
| 51415 | Other | FL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY5826 (Florida) | Primary |
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