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General NPI Number Information
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NPI Number | 1558424267
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Entity Type | Organization
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Legal Business Name | FEMININSIGHT INC
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 405 JULIA PL
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City | SARASOTA
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State | FL
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Zip | 34236-6915
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Country | US
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Telephone | 941-412-3947
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Fax | 941-412-3957
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Provider Business Mailing Address
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Address Line | 173 VENICE PALMS BLVD.
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City | VENICE
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State | FL
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Zip | 34292
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Country | US
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Telephone | 941-412-3947
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Fax | 941-412-3957
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARY THEODORA CARROLL
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Credential | PHD
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Telephone | 941-412-3947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH0002776
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License Number State | FL
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