| Organization Name: | EAGLE VISION CONSULTING & LIFE ENRICHMENT SERVICES, INC. |
| NPI Number: | 1114950664 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CANDICE KAY STEWART-SABIN (CLINICAL PSYCHOLOGIST) |
| Mailing Address: | 132 10th Ave N Suite 103 Safety Harbor |
| State: | FL US |
| Postal Code: | 346953407 |
| Phone Number: | 7277918040 |
| Fax Number: | 7277918045 |
| NPI Enumeration Date: | 07/08/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY7296 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |