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General NPI Number Information
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NPI Number | 1700274537
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Entity Type | Organization
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Legal Business Name | PEGGY ALBANO THERAPY LLC
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Dates
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Enumeration Date | 01/01/2015
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Last Update Date | 01/01/2015
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Provider Practice Location Address
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Address Line | 269 S OSPREY AVE SUITE 200
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City | SARASOTA
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State | FL
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Zip | 34236-6805
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Country | US
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Telephone | 941-914-5553
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Fax |
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Provider Business Mailing Address
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Address Line | 269 S OSPREY AVE SUITE 200
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City | SARASOTA
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State | FL
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Zip | 34236-6805
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Country | US
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Telephone | 941-914-5553
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. PEGGY A ALBANO
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Credential | MA
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Telephone | 941-914-5553
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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 | IMH9707
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License Number State | FL
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