| Doctor Name: | COLLEEN WAY |
| NPI Number: | 1053740555 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMHC |
| License Number: | MH 12083 |
| Business Practice Address: | 505 Avenue B Nw Winter Haven, FL - 338814607 |
| Business Phone Number: | 8634125161 |
| Business Fax Number: | |
| Mailing Address: | 706 Avenue T Se, WINTER HAVEN |
| State: | FL |
| Postal Code: | 338804720 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 11/05/2013 |
| NPI Last Update Date: | 11/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH 12083 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |