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General NPI Number Information
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NPI Number | 1275004608
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Entity Type | Organization
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Legal Business Name | CENTER FOR DYNAMIC HEALING, INC
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Dates
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Enumeration Date | 12/11/2018
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Last Update Date | 06/14/2021
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Provider Practice Location Address
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Address Line | 40946 US HIGHWAY 19 N # 421
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-5446
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Country | US
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Telephone | 224-828-9877
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Fax |
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Provider Business Mailing Address
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Address Line | 40946 US HIGHWAY 19 N # 421
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-5446
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Country | US
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Telephone | 224-828-9877
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | LYNN LEANN BARRETTE
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Credential |
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Telephone | 224-828-9877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282J00000X
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Taxonomy Name | Religious Nonmedical Health Care Institution
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License Number |
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License Number State |
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Taxonomy #2
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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 |
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