Laura Ann Stafford LICSW

NPI 1104050178 - Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X

NPI Details
NPI 1104050178
Gender Female
Enumeration Date 05/06/2009
Last Updated 04/01/2015
Entity Type Individual
Active Over 7 years ago
Practice Location
12550 NEW BRITTANY BLVD
SUITE 201
FORT MYERS FL, 33907-3655, US
Phone (239) 343-9190
Fax
Business Location
12550 NEW BRITTANY BLVD
SUITE 201
FORT MYERS FL, 33907-3655, US
Phone (239) 343-9190
Fax
Toxanomy
Taxonomy Code 322D00000X
License State Massachusetts
License Number 111844
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According to our database, Mrs. Laura Ann Stafford LICSW NPI is 1104050178, taxonomy code is 322D00000X and license number is 111844, license state is located at Massachusetts. Laura Ann Stafford LICSW physically located at 12550 New Brittany Blvd, Fort Myers FL, 33907-3655. NPI Number Laura Ann Stafford LICSW has the Individual type.

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1104050178 NPI number is provided on an as is basis without warranty of any kind. 1104050178 is maintained by the National Plan & Provider Enumeration System. The contents of Laura Ann Stafford LICSW are for informational purposes only.