Stomptherapy LLC
NPI #1235585837 in Georgetown, Texas
Provider Information
- NPI Number
- 1235585837
- Entity Type
- Organization
- Organization Name
- Stomptherapy LLC
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- May 12, 2016
- Last Updated
- May 12, 2016
Practice Location
- Address
- 201 DUCK CREEK LN
- City
- Georgetown
- State
- Texas
- ZIP Code
- 78633-4114
- Phone
- (850) 543-7776
Authorized Official
- Name
- MR. GERALD DAVID NICKLEN, LICSW
- Title
- PRESIDENT STOMPTHERAPY, LLC
- Phone
- (850) 543-7776
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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