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General NPI Number Information
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NPI Number | 1003351966
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Entity Type | Organization
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Legal Business Name | DNA COMPREHENSIVE THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 01/03/2017
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 19531 COCHRAN BLVD
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948-2081
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Country | US
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Telephone | 239-223-2751
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Fax |
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Provider Business Mailing Address
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Address Line | 4310 METRO PKWY STE 205
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City | FORT MYERS
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State | FL
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Zip | 33916-9416
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Country | US
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Telephone | 833-362-7935
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Fax | 239-561-2933
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Authorized Official
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Title or Position | CEO
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Name | MRS. ELIZABETH N. DOSORETZ
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Credential | LCSW
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Telephone | 239-236-8784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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