| Mending Wings Inc | |
|
1138 Vizcaya Lakes Rd Apt 104 Ocoee FL 34761-6957 | |
| (404) 441-2379 | |
| (407) 297-8779 |
| Full Name | Mending Wings Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1138 Vizcaya Lakes Rd, Ocoee, Florida |
| Authorized Official Name and Position | Latonya Tomika Sherman (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4044412379 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mending Wings Inc 1138 Vizcaya Lakes Rd Apt 104 Ocoee FL 34761-6957 Ph: (404) 441-2379 | Mending Wings Inc 1138 Vizcaya Lakes Rd Apt 104 Ocoee FL 34761-6957 Ph: (404) 441-2379 |
| NPI Number | 1518101807 |
|---|---|
| Provider Enumeration Date | 04/30/2009 |
| Last Update Date | 04/30/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518101807 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | () | Primary |
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