Provider Demographics
NPI:1063282267
Name:MY THERAPY PARTNER, INC
Entity type:Organization
Organization Name:MY THERAPY PARTNER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANESS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:866-441-6002
Mailing Address - Street 1:6223 HIGHWAY 90 STE 282
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-1705
Mailing Address - Country:US
Mailing Address - Phone:866-441-6002
Mailing Address - Fax:
Practice Address - Street 1:6196 CLEAR CREEK ROAD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570
Practice Address - Country:US
Practice Address - Phone:866-441-6002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty