Provider Demographics
NPI:1417373242
Name:POSITIVE TRANSFORMATIONS PA
Entity Type:Organization
Organization Name:POSITIVE TRANSFORMATIONS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:THATCHER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:813-677-6444
Mailing Address - Street 1:10021 WATER WORKS LN
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-5304
Mailing Address - Country:US
Mailing Address - Phone:813-677-6444
Mailing Address - Fax:813-677-7999
Practice Address - Street 1:10021 WATER WORKS LN
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-5304
Practice Address - Country:US
Practice Address - Phone:813-677-6444
Practice Address - Fax:813-677-7999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 8912103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty