| 363 Therapy, Llc | |
|
4800 W Commercial Blvd Tamarac FL 33319-2879 | |
| (954) 805-4509 | |
| Not Available |
| Full Name | 363 Therapy, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4800 W Commercial Blvd, Tamarac, Florida |
| Authorized Official Name and Position | Andrea Santiago (OWNER) |
| Authorized Official Contact | 9548054509 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 363 Therapy, Llc 4800 W Commercial Blvd Tamarac FL 33319-2879 Ph: (954) 805-4509 | 363 Therapy, Llc 4800 W Commercial Blvd Tamarac FL 33319-2879 Ph: (954) 805-4509 |
| NPI Number | 1295110120 |
|---|---|
| Provider Enumeration Date | 07/21/2015 |
| Last Update Date | 10/30/2020 |
| Certification Date | 10/30/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295110120 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW12275 (Florida) | Primary |
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