Provider Demographics
NPI:1316268121
Name:PREDESTINED FOR PURPOSE
Entity type:Organization
Organization Name:PREDESTINED FOR PURPOSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BOBBIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-285-1249
Mailing Address - Street 1:PO BOX 616753
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32861-6753
Mailing Address - Country:US
Mailing Address - Phone:407-285-1249
Mailing Address - Fax:407-704-1677
Practice Address - Street 1:5527 PINE CHASE DR
Practice Address - Street 2:8
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32808-4345
Practice Address - Country:US
Practice Address - Phone:407-285-1249
Practice Address - Fax:407-704-1677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty