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General NPI Number Information
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NPI Number | 1710793930
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Entity Type | Organization
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Legal Business Name | EXPRESSIVE ARTS FLORIDA, LLC
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Dates
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Enumeration Date | 12/04/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 46 N WASHINGTON BLVD UNIT 8
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City | SARASOTA
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State | FL
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Zip | 34236-5928
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Country | US
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Telephone | 941-366-9595
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 52335
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City | SARASOTA
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State | FL
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Zip | 34232-0319
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Country | US
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Telephone | 941-366-9595
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TAMARA KNAPP
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Credential | LMHC
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Telephone | 941-366-6954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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