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General NPI Number Information
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NPI Number | 1568927705
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Entity Type | Organization
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Legal Business Name | PEACEFUL PRANA THERAPY, LLC
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Dates
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Enumeration Date | 02/01/2019
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Last Update Date | 01/18/2020
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Provider Practice Location Address
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Address Line | 2300 E OAKLAND PK BLVD STE 206
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City | PLANTATION
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State | FL
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Zip | 33306
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Country | US
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Telephone | 954-715-6050
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Fax | 866-757-5778
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Provider Business Mailing Address
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Address Line | 4737 N OCEAN DR # 184
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City | LAUDERDALE BY THE SEA
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State | FL
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Zip | 33308-2920
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Country | US
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Telephone | 954-715-6050
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH P SUMPF
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Credential | LCSW
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Telephone | 954-715-6050
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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 |
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License Number State |
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