Provider Demographics
NPI:1033771456
Name:MURAILLE, ENDREA (MS)
Entity Type:Individual
Prefix:
First Name:ENDREA
Middle Name:
Last Name:MURAILLE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:581 N PARK AVE # 2462
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-3525
Mailing Address - Country:US
Mailing Address - Phone:470-798-8972
Mailing Address - Fax:
Practice Address - Street 1:1975 S JOHN YOUNG PKWY # 203A
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-0603
Practice Address - Country:US
Practice Address - Phone:470-798-8972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-05
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health