Healthcare Provider Details

I. General information

NPI: 1558275222
Provider Name (Legal Business Name): HANNAH CLONCH, LLC DBA GROW THROUGH TRAUMA THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3677 CENTRAL AVE
FORT MYERS FL
33901-8226
US

IV. Provider business mailing address

27865 SOLIS GRANDE DR
BONITA SPRINGS FL
34135-3573
US

V. Phone/Fax

Practice location:
  • Phone: 239-823-7476
  • Fax:
Mailing address:
  • Phone: 239-823-7476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: HANNAH CLONCH
Title or Position: OWNER
Credential:
Phone: 239-823-7476