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General NPI Number Information
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NPI Number | 1538536248
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Entity Type | Organization
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Legal Business Name | RONDA MITCHELL-COSGROVE, MSW, LCSW
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Dates
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Enumeration Date | 08/28/2015
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Last Update Date | 08/28/2015
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Provider Practice Location Address
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Address Line | 3890 E STATE ROAD 64
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City | BRADENTON
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State | FL
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Zip | 34208-9040
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Country | US
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Telephone | 941-468-1721
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Fax | 941-355-5358
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Provider Business Mailing Address
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Address Line | 3890 E STATE ROAD 64
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City | BRADENTON
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State | FL
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Zip | 34208-9040
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Country | US
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Telephone | 941-468-1721
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Fax | 941-355-5358
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | RONDA MITCHELL-COSGROVE
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Credential | MSW, LCSW
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Telephone | 941-468-1721
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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 | SW9146
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License Number State | FL
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