# GROW AND GLOW THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649118720
- **Authorized official:** BLAIR-TIFFANY MCCORMICK (CEO)
- **Authorized official phone:** (813) 701-8161

## Contact information

- **Practice address:** 710 OAKFIELD DR STE 221, BRANDON, FL 33511-4924
- **Practice address phone:** (813) 701-8161
- **Mailing address:** 11001 GOLDEN SILENCE DR, RIVERVIEW, FL 33579-2341
- **Mailing address phone:** (813) 701-8161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 261QD1600X | Developmental Disabilities Clinic/Center | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/23/2026
- **Last updated:** 03/23/2026