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Mrs. Laura Ann Stafford, LICSW
Emotionally Disturbed Childrens' Residential Treatment Facility in Fort Myers, Florida
NPI 1104050178

Laura Ann Stafford is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Fort Myers, FL. Laura Ann Stafford practices in Fort Myers, FL and has the professional credentials of LICSW. The NPI Number for Laura Ann Stafford is 1104050178 and holds a License No. 111844 (Florida).

The current practice location address for Laura Ann Stafford is 12550 New Brittany Blvd, Fort Myers, FL and can be reached out via phone at 239-343-9190.

Location: 12550 New Brittany Blvd, Fort Myers, FL, 33907-3655
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104050178
Provider Name
Laura Ann Stafford
Credential
LICSW
Provider Entity Type
Individual
Gender
Female
Address
12550 New Brittany Blvd, Fort Myers, FL, 33907-3655
Phone Number
239-343-9190
Fax Number
Provider Enumeration Date
05/06/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
12550 New Brittany Blvd
City
Fort Myers
State
Florida
Zip
33907-3655
Phone Number
239-343-9190
Fax Number
person
Provider Business Mailing Address Details
Address
12550 New Brittany Blvd
City
Fort Myers
State
Florida
Zip
33907-3655
Phone Number
239-343-9190
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
322D00000X
License No.
111844 (Massachusetts)
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
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