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General NPI Number Information
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NPI Number | 1336654235
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Entity Type | Organization
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Legal Business Name | MINDWORKS ASSESSMENT
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Dates
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Enumeration Date | 12/13/2017
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Last Update Date | 12/13/2017
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Provider Practice Location Address
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Address Line | 15961 N FLORIDA AVE STE C
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City | LUTZ
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State | FL
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Zip | 33549-8101
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Country | US
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Telephone | 813-559-0909
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 N PERRY AVE
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City | TAMPA
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State | FL
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Zip | 33603-5237
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Country | US
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Telephone | 813-956-9213
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JULIE ANNE GETTMAN
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Credential | PHD
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Telephone | 813-559-0909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | SS810
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License Number State | FL
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