Mending Wings INC

NPI #1518101807 in Ocoee, Florida

Provider Information

NPI Number: 1518101807
Entity Type: Organization
Organization Name: Mending Wings INC
Primary Specialty: Counselor - Professional
Enumeration Date: Apr 30, 2009
Last Updated: Apr 30, 2009

Practice Location

Address: 1138 VIZCAYA LAKES RD
Address 2: APT 104
City: Ocoee
State: Florida
ZIP Code: 34761-6957
Phone: (404) 441-2379

Authorized Official

Name: MS. LATONYA TOMIKA SHERMAN, MPA, CMHP
Title: EXECUTIVE DIRECTOR
Phone: (404) 441-2379

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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