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General NPI Number Information
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NPI Number | 1750254579
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Entity Type | Organization
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Legal Business Name | FAMILY THERAPY CENTER OF THE SOUTHEAST LLC
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Dates
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Enumeration Date | 09/26/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 3508 CHESAPEAKE DR
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City | FLORENCE
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State | AL
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Zip | 35630-6386
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Country | US
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Telephone | 336-317-7157
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2095
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City | FLORENCE
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State | AL
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Zip | 35630-0001
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Country | US
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Telephone | 336-317-7157
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANDREW MARK JAMIESON
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Credential | PHD
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Telephone | 336-371-7157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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