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Organization

FUNDAMENTAL PSYCHOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANGELA STERANKO PSY.D. (OWNER/FOUNDER)
(941) 275-9183
Entity
Organization

Contact information

Practice address
1505 TAMIAMI TRL S STE 402, VENICE, FL 34285-5563
(941) 275-9183
Mailing address
1505 TAMIAMI TRL S STE 402, VENICE, FL 34285-5563
(941) 275-9183

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103T00000X
Psychologist
Primary
103TC2200X
Clinical Child & Adolescent Psychologist
106H00000X
Marriage & Family Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023436987
FL
05
1497986467
FL
Enumeration date
04/11/2019
Last updated
06/11/2019
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