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4335 Reding Way Lakeland FL 33813-4481 | |
| (971) 599-2251 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 4335 Reding Way, Lakeland, Florida |
| Authorized Official Name and Position | Stephanie Giddings (PRESIDENT) |
| Authorized Official Contact | 9715992251 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4676 Commercial St Se Salem OR 97302-1902 Ph: (971) 599-2251 | 4335 Reding Way Lakeland FL 33813-4481 Ph: (971) 599-2251 |
| NPI Number | 1447841820 |
|---|---|
| Provider Enumeration Date | 01/28/2021 |
| Last Update Date | 06/02/2021 |
| Certification Date | 06/02/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447841820 | NPI | - | NPPES |
| 500704895 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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