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General NPI Number Information
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NPI Number | 1780017244
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Entity Type | Organization
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Legal Business Name | GULF COAST THERAPY CONNECTION, PLLC.
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Dates
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Enumeration Date | 08/19/2013
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Last Update Date | 08/19/2013
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Provider Practice Location Address
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Address Line | 1789 BAYSHORE BLVD
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City | DUNEDIN
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State | FL
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Zip | 34698-3343
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Country | US
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Telephone | 813-298-4192
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Fax |
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Provider Business Mailing Address
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Address Line | 1789 BAYSHORE BLVD
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City | DUNEDIN
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State | FL
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Zip | 34698-3343
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Country | US
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Telephone | 813-298-4192
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARGRIT H. GOODHAND
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Credential | LCSW
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Telephone | 813-298-4192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW9212
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License Number State | FL
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