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General NPI Number Information
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NPI Number | 1376406660
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Entity Type | Organization
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Legal Business Name | DNA COMPREHENSIVE THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 475 W TOWN PL STE 210
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-3648
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Country | US
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Telephone | 833-362-7935
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Fax |
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Provider Business Mailing Address
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Address Line | 4310 METRO PKWY STE 205
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City | FORT MYERS
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State | FL
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Zip | 33916-9416
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Country | US
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Telephone | 239-223-2751
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | ELIZABETH NOEMI DOSORETZ
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Credential |
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Telephone | 239-223-2751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #5
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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 |
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License Number State |
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