Individual provider · NPI-1

Earlyssia Austin

Counselor · Daytona Beach, FL

NPI number1205290632
StatusActive
Last updated in NPPESApr 19, 2016

Details

NPI
1205290632
Entity type
Individual (NPI-1)
Name
Earlyssia Austin
Sex
Female
Sole proprietor
No
Enumeration date
Apr 12, 2016
Last updated
Apr 19, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101Y00000X Counselor––Yes

Practice location

2400 S Ridgewood Ave
Suite 32
Daytona Beach, FL 32114-7164

Phone 386-304-7600

Mailing address

2400 S Ridgewood Ave
Suite 32
Daytona Beach, FL 32114-7164

Phone 386-304-7600

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