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General NPI Number Information
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NPI Number | 1407337512
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Entity Type | Organization
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Legal Business Name | GLOBAL THERAPY AND WELLNESS, PLLC
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 6112 45TH STREET WEST
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City | BRADENTON
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State | FL
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Zip | 34210
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Country | US
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Telephone | 631-327-6500
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Fax |
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Provider Business Mailing Address
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Address Line | 6112 45TH STREET WEST
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City | BRADENTON
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State | FL
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Zip | 34210
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Country | US
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Telephone | 941-666-0669
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. LENORE FELICE CANAVARROS
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Credential | LCSW
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Telephone | 631-327-6500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW12524
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License Number State | FL
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