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General NPI Number Information
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NPI Number | 1548726714
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Entity Type | Organization
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Legal Business Name | MOVING TOWARD AGAPE, LLC
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Dates
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Enumeration Date | 02/13/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 15715 S DIXIE HWY STE 403
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City | PALMETTO BAY
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State | FL
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Zip | 33157-1812
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Country | US
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Telephone | 813-803-0918
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Fax |
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Provider Business Mailing Address
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Address Line | 15715 S DIXIE HWY STE 403
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City | PALMETTO BAY
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State | FL
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Zip | 33157-1812
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Country | US
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Telephone | 813-803-0918
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | MRS. BARBARA PADRON
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Credential | LMFT
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Telephone | 305-281-4954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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