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General NPI Number Information
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NPI Number | 1528706991
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Entity Type | Organization
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Legal Business Name | JUST PSYCH LLC
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Dates
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Enumeration Date | 05/25/2022
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Last Update Date | 05/25/2022
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Provider Practice Location Address
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Address Line | 110 ATHENS STREET STE O
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-3304
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Country | US
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Telephone | 727-249-4898
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Fax | 727-295-1648
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Provider Business Mailing Address
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Address Line | 110 ATHENS STREET STE O
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City | TARPON SPRINGS
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State | FL
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Zip | 34689-3304
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Country | US
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Telephone | 727-249-4898
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Fax | 727-295-1648
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Authorized Official
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Title or Position | MEMBER
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Name | SANDRA L RISOLDI
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Credential | PMHNP
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Telephone | 727-249-4898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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