Organization
CHANGE & GROWTH THERAPY CENTER
Active
Organization
CHANGE & GROWTH THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MAYRA BAGNOLI (OWNER)
(561) 635-2341
Entity
Organization
Contact information
Practice address
8401 LAKE WORTH RD, STE. 202, LAKE WORTH, FL 33467-2400
(561) 635-2431
Mailing address
8401 LAKE WORTH RD, STE. 202, LAKE WORTH, FL 33467-2400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW12223
FL
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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