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NPI 1710246632

NPI 1710246632 : THERESA A USHER LCSW, MSW : LARGO, FL

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General NPI Number Information
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    NPI Number           |    1710246632
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    Entity Type          |    Individual 
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    Provider Name        |    THERESA A USHER LCSW, MSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/12/2012
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    Last Update Date     |    05/12/2012
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Provider Practice Location Address
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    Address Line         |    624 SHORE DR 
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    City                 |    LARGO
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    State                |    FL
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    Zip                  |    33771-1535
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    Country              |    US
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    Telephone            |    727-729-5543
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    624 SHORE DR 
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    City                 |    LARGO
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    State                |    FL
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    Zip                  |    33771-1535
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    SW9027
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    License Number State |    FL
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