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Contact Information

BACK DOOR, LLC
1639 CAPE CORAL PKWY E STE 211
CAPE CORAL, FL33904-9657
 Phone: 239-745-5917
 Fax: 866-676-2762
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Prescribing (Medical)

103TP0016X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for BACK DOOR LLC · (Female)

NPI Number 1982836391
Status Active
Credentials
Entity Individual
Enumeration date 08/18/2009
Last updated 11/17/2009 - About 17 years ago
Sole proprietor 1 Not specified
Identifiers
  • FL License # ME100060
  • FL License # SW8039
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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