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General NPI Number Information
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NPI Number | 1750931622
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Entity Type | Organization
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Legal Business Name | STRENGTH BASED THERAPY, PLLC
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Dates
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Enumeration Date | 09/12/2019
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Last Update Date | 09/12/2019
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Provider Practice Location Address
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Address Line | 4090 DELTONA BLVD
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City | SPRING HILL
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State | FL
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Zip | 34606-2203
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Country | US
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Telephone | 631-848-2235
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Fax |
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Provider Business Mailing Address
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Address Line | 14143 HOLLY HAMMOCK LN
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City | BROOKSVILLE
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State | FL
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Zip | 34613-6863
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Country | US
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Telephone | 631-848-2235
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | SUSAN M ROY
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Credential |
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Telephone | 631-848-2235
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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