Doctor Name: | CHRISTOPHER SOMMERLAD |
NPI Number: | 1083017917 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A. |
License Number: | |
Business Practice Address: | 3491 Gandy Blvd N Pinellas Park, FL - 337812658 |
Business Phone Number: | 7275470607 |
Business Fax Number: | |
Mailing Address: | 3491 Gandy Blvd N, PINELLAS PARK |
State: | FL |
Postal Code: | 337812658 |
Phone Number: | 7275470607 |
Fax Number: | |
NPI Enumeration Date: | 10/06/2014 |
NPI Last Update Date: | 10/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |