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General NPI Number Information
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NPI Number | 1013821560
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Entity Type | Organization
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Legal Business Name | SUNFLOWER THERAPY LLC
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 522 W RIVERSIDE AVE
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City | SPOKANE
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State | WA
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Zip | 99201-0580
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Country | US
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Telephone | 407-735-6176
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Fax | 407-487-8152
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Provider Business Mailing Address
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Address Line | 156 TOLLGATE TRL
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City | LONGWOOD
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State | FL
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Zip | 32750-3855
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Country | US
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Telephone | 407-920-5270
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Fax | 407-487-8152
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Authorized Official
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Title or Position | CLINICAL THERAPIST, OWNER
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Name | JESSICA ELIZABETH DOMINGO
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Credential | LCSW
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Telephone | 407-735-6176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | NULL
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