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General NPI Number Information
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NPI Number | 1619223468
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Entity Type | Organization
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Legal Business Name | TRANQUIL MIND PLC
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 09/24/2012
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Provider Practice Location Address
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Address Line | 1858 N ALAFAYA TRL STE. 204
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City | ORLANDO
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State | FL
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Zip | 32826-4728
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Country | US
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Telephone | 407-491-1818
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Fax | 407-745-0598
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Provider Business Mailing Address
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Address Line | PO BOX 620321
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City | OVIEDO
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State | FL
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Zip | 32762-0321
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Country | US
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Telephone | 407-491-1818
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Fax | 407-745-0598
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Authorized Official
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Title or Position | OWNER
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Name | PEGGY ANN HIGHTOWER
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Credential | MSW, LCSW
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Telephone | 407-491-1818
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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 | SW10425
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License Number State | FL
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