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General NPI Number Information
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NPI Number | 1356040869
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Entity Type | Organization
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Legal Business Name | UNIVERSAL THERAPY AND WELLNESS
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Dates
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Enumeration Date | 02/23/2023
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Last Update Date | 02/23/2023
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Provider Practice Location Address
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Address Line | 2905 RIGSBY LN
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City | SAFETY HARBOR
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State | FL
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Zip | 34695-4831
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Country | US
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Telephone | 813-308-9050
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Fax |
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Provider Business Mailing Address
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Address Line | 14906 OLDGATE PL
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City | TAMPA
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State | FL
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Zip | 33624-2026
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Country | US
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Telephone | 321-289-0151
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TIFFANI HARDIN
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Credential | LMHC
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Telephone | 813-308-9050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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