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General NPI Number Information
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NPI Number | 1255912895
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Entity Type | Individual
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Provider Name | JANICE MARIE HANNAH CAP
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Gender | Female
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Dates
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Enumeration Date | 04/15/2021
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Last Update Date | 04/15/2021
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Provider Practice Location Address
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Address Line | 203 3RD AVE E
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City | BRADENTON
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State | FL
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Zip | 34208-1013
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Country | US
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Telephone | 219-242-9462
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Fax |
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Provider Business Mailing Address
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Address Line | 5114 ESTATES CIR
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City | SARASOTA
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State | FL
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Zip | 34243-4925
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Country | US
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Telephone | 219-242-9462
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CAP100254
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License Number State | FL
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