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General NPI Number Information
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NPI Number | 1013148261
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Entity Type | Organization
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Legal Business Name | STRUCTURAL ENERGETIC THERAPY INC
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 08/06/2009
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Provider Practice Location Address
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Address Line | 156B WHITAKER RD
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City | LUTZ
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State | FL
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Zip | 33544-5792
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Country | US
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Telephone | 813-949-2933
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Fax | 813-944-2797
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Provider Business Mailing Address
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Address Line | 156B WHITAKER RD
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City | LUTZ
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State | FL
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Zip | 33544-5792
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Country | US
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Telephone | 813-949-2933
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Fax | 813-944-2797
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Authorized Official
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Title or Position | THERAPIST
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Name | MR. DONALD B MCCANN
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Credential | LMHC
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Telephone | 813-949-2933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH705
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License Number State | FL
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