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General NPI Number Information
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NPI Number | 1841093960
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Entity Type | Organization
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Legal Business Name | DENA PANICCIA LLC
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Dates
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Enumeration Date | 04/01/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 6315 PRESIDENTIAL CT STE 110
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City | FORT MYERS
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State | FL
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Zip | 33919-3568
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Country | US
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Telephone | 239-450-7155
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Fax |
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Provider Business Mailing Address
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Address Line | 1113 NW 12TH LN
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City | CAPE CORAL
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State | FL
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Zip | 33993-6091
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DENA PANICCIA
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Credential |
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Telephone | 239-450-7155
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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 |
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License Number State |
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