Organization
GPS II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWNA J MCDONOUGH (PRESIDENT)
(813) 495-7769
Entity
Organization
Contact information
Practice address
6603 GULFSIDE RD, LONGBOAT KEY, FL 34228-1416
(813) 495-7769
(813) 935-4771
Mailing address
6603 GULFSIDE RD, LONGBOAT KEY, FL 34228-1416
(813) 495-7769
(813) 935-4771
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
—
—
Other
Enumeration date
08/23/2012
Last updated
09/19/2012
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