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General NPI Number Information
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NPI Number | 1144690199
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Entity Type | Organization
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Legal Business Name | A CAUSE FOR SUCCESS
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Dates
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Enumeration Date | 10/02/2015
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Last Update Date | 10/02/2015
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Provider Practice Location Address
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Address Line | 9180 ESTERO PARK COMMONS BLVD SUITE #6
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City | ESTERO
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State | FL
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Zip | 33928-3218
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Country | US
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Telephone | 407-506-7097
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Fax |
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Provider Business Mailing Address
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Address Line | 3130 SEASONS WAY UNIT 407
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City | ESTERO
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State | FL
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Zip | 33928-2304
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Country | US
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Telephone | 407-506-7097
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MICHELE BAND
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Credential | MA, LMFT, CSAT
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Telephone | 407-506-7097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT 2952
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License Number State | FL
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