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General NPI Number Information
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NPI Number | 1285884270
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Entity Type | Individual
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Provider Name | ALESSANDRA VALERIE MEYRICK LMT
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Gender | Female
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Dates
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Enumeration Date | 09/25/2008
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Last Update Date | 09/25/2008
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Provider Practice Location Address
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Address Line | 721 DESOTO AVE
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City | LEHIGH ACRES
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State | FL
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Zip | 33972-7936
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Country | US
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Telephone | 239-243-6621
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 82
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City | ALVA
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State | FL
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Zip | 33920-0082
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Country | US
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Telephone | 239-243-6621
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number | MA 48485
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License Number State | FL
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