NPI 1104177948

Enloe Bruce Billingsley LCSW PA

Organisation Counselor Brandon, FL

Practice location

Address: 1210 Millennium Pkwy Suite 1030, Brandon, FL 33511-4896
Phone: (813) 654-8916
Fax: (813) 654-6952
Mailing address: 1210 Millennium Parkway Suite 1030, Brandon, FL 33511-4858

Authorised official

Name: Enloe Bruce Billingsley
Title: LCSW
Phone: (813) 654-8916

Registered specialties

Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101Y00000X Licence SW0000194 (FL)

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Registry record

NPI: 1104177948
Entity type: Organization
NPI issued: 19 Sep 2012
Record last updated: 19 Sep 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.