| Mending Wounded Souls, Pllc | |
|
7190 Seminole Blvd Seminole FL 33772-5935 | |
| (727) 466-8559 | |
| Not Available |
| Full Name | Mending Wounded Souls, Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 7190 Seminole Blvd, Seminole, Florida |
| Authorized Official Name and Position | Ann Depoolw (MANAGER) |
| Authorized Official Contact | 7274668559 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mending Wounded Souls, Pllc 1001 Starkey Rd #67 Largo FL 33771-5495 Ph: (727) 466-8559 | Mending Wounded Souls, Pllc 7190 Seminole Blvd Seminole FL 33772-5935 Ph: (727) 466-8559 |
| NPI Number | 1467984179 |
|---|---|
| Provider Enumeration Date | 03/31/2017 |
| Last Update Date | 03/31/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467984179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW11317 (Florida) | Primary |
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