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General NPI Number Information
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NPI Number | 1922579069
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Entity Type | Organization
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Legal Business Name | SUSAN WEXLER CRATER LCSW LLC
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Dates
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Enumeration Date | 12/16/2018
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Last Update Date | 12/16/2018
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Provider Practice Location Address
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Address Line | 9114 58TH DR E STE 114
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City | BRADENTON
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State | FL
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Zip | 34202-9074
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Country | US
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Telephone | 941-961-8852
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Fax |
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Provider Business Mailing Address
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Address Line | 4821 ROYAL DORNOCH CIR
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City | BRADENTON
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State | FL
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Zip | 34211-8444
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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 | SUSAN WEXLER CRATER
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Credential | LCSW
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Telephone | 941-961-8852
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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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