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General NPI Number Information
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NPI Number | 1487050597
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Entity Type | Organization
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Legal Business Name | BOARDPREP, LLC
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Dates
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Enumeration Date | 11/17/2014
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Last Update Date | 07/20/2015
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Provider Practice Location Address
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Address Line | 2522 W KENNEDY BLVD
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City | TAMPA
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State | FL
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Zip | 33609-3306
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Country | US
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Telephone | 800-520-8475
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Fax | 813-673-8000
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Provider Business Mailing Address
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Address Line | 2522 W KENNEDY BLVD
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City | TAMPA
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State | FL
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Zip | 33609-3306
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Country | US
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Telephone | 800-520-8475
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Fax | 813-673-8000
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Authorized Official
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Title or Position | OWNER
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Name | JOHN HARDEN
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Credential | LCSW
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Telephone | 800-520-8475
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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 | SW5348
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License Number State | FL
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