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General NPI Number Information
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NPI Number | 1730556507
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Entity Type | Organization
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Legal Business Name | LAURIE A. SPATARO
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Dates
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Enumeration Date | 08/27/2015
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Last Update Date | 08/27/2015
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Provider Practice Location Address
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Address Line | 1490 S MILITARY TRL SUITE 7
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-9190
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Country | US
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Telephone | 561-713-8511
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Fax |
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Provider Business Mailing Address
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Address Line | 9589 VERONA LAKES BLVD
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-2759
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Country | US
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Telephone | 561-713-8511
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | LAURIE A SPATARO
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Credential | M.A., C.A.P.
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Telephone | 561-713-8511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ADC0075712015
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License Number State | FL
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