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General NPI Number Information
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NPI Number | 1689118499
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Entity Type | Organization
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Legal Business Name | GIENA COBB, PA.
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Dates
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Enumeration Date | 12/13/2016
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 501 GOODLETTE RD N D-100
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City | NAPLES
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State | FL
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Zip | 34102-5661
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Country | US
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Telephone | 239-777-2613
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 110863
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City | NAPLES
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State | FL
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Zip | 34108-0115
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Country | US
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Telephone | 239-777-2613
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GIENA COBB
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Credential | PA, LMHC
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Telephone | 239-777-2613
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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 | MH8363
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License Number State | FL
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