Healthcare Provider Details

I. General information

NPI: 1568032647
Provider Name (Legal Business Name): CHILDREN'S THERAPY SOLUTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2021
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3823 E STATE ROAD 64
BRADENTON FL
34208-9041
US

IV. Provider business mailing address

3823 E STATE ROAD 64
BRADENTON FL
34208-9041
US

V. Phone/Fax

Practice location:
  • Phone: 941-745-5111
  • Fax:
Mailing address:
  • Phone: 941-745-5111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: LENA THORESEN
Title or Position: PRESIDENT
Credential:
Phone: 941-745-5111