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General NPI Number Information
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NPI Number | 1447926621
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Entity Type | Individual
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Provider Name | SAVANNAH CUDDY RMHCI
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Gender | Female
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Dates
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Enumeration Date | 08/18/2021
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 759 SW FEDERAL HWY
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City | STUART
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State | FL
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Zip | 34994-2914
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Country | US
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Telephone | 772-281-0599
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Fax |
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Provider Business Mailing Address
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Address Line | 593 SW SAINT JOHNS BAY
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City | PORT ST LUCIE
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State | FL
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Zip | 34986-3410
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Country | US
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Telephone | 561-403-6218
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH26192
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-19-104102
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License Number State | FL
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