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General NPI Number Information
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NPI Number | 1659694842
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Entity Type | Organization
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Legal Business Name | LASANDRA L. MCGREW AND ASSOCIATES, LLC
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Dates
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Enumeration Date | 03/02/2010
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Last Update Date | 11/21/2011
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Provider Practice Location Address
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Address Line | 1411 OAKFIELD DR
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City | BRANDON
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State | FL
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Zip | 33511-2800
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Country | US
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Telephone | 813-689-3700
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Fax | 813-689-8100
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Provider Business Mailing Address
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Address Line | 1411 OAKFIELD DR
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City | BRANDON
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State | FL
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Zip | 33511-2800
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Country | US
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Telephone | 813-689-3700
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Fax | 813-689-8100
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Authorized Official
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Title or Position | CEO
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Name | MRS. LASANDRA L. MCGREW
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Credential | LCSW
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Telephone | 813-689-3700
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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 | SW9377
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License Number State | FL
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