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General NPI Number Information
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NPI Number | 1740489368
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Entity Type | Organization
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Legal Business Name | NEW OBJECTIVES PSYCHOLOGY, COUNSELING & NEUROFEEDBACK CENTER
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 620 CROWN OAK CENTRE DR
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City | LONGWOOD
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State | FL
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Zip | 32750-6188
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Country | US
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Telephone | 407-339-1159
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Fax | 407-339-2405
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Provider Business Mailing Address
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Address Line | 620 CROWN OAK CENTRE DR
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City | LONGWOOD
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State | FL
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Zip | 32750-6188
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Country | US
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Telephone | 407-339-1159
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Fax | 407-339-2405
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHARON R. THETFORD
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Credential | PSY. D.
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Telephone | 407-339-1159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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