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General NPI Number Information
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NPI Number | 1558147132
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Entity Type | Individual
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Provider Name | KELLIE-ANN PATRICE TORRES LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/07/2023
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 8359 BEACON BLVD STE 312
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City | FORT MYERS
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State | FL
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Zip | 33907-3062
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Country | US
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Telephone | 239-691-2520
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Fax | 239-986-8014
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Provider Business Mailing Address
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Address Line | 8359 BEACON BLVD STE 312
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City | FORT MYERS
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State | FL
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Zip | 33907-3062
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Country | US
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Telephone | 239-691-2520
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Fax | 239-986-8014
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | MT4712
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License Number State | FL
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