Provider Demographics
NPI:1730474081
Name:TRUELOVE, BRYAN (LMHC)
Entity type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:
Last Name:TRUELOVE
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 MOSSYROCK AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-2432
Mailing Address - Country:US
Mailing Address - Phone:321-356-0771
Mailing Address - Fax:
Practice Address - Street 1:2101 PARK CENTER DR
Practice Address - Street 2:SUITE 270
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-7626
Practice Address - Country:US
Practice Address - Phone:407-523-1213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10785101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health