NPI 1104050178

Laura Ann Stafford, LICSW

Practitioner Emotionally Disturbed Childrens' Residential Treatment Facility Fort Myers, FL

Practice location

Address: 12550 New Brittany Blvd Suite 201, Fort Myers, FL 33907-3655
Phone: (239) 343-9190

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence 111844 (MA)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Florida →

Registry record

NPI: 1104050178
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 May 2009
Record last updated: 1 Apr 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.