Provider Information for 1114342888
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Mrs. MARY TABOR MCDANIELS LCSW
Sex: Female
NPI: 1114342888
Last Updated: 2014-03-04
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1114342888 | ||||||||
| Enumeration Date | 2014-03-04 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 5707 N 22ND ST TAMPA, FL 33610-4350 United States Phone: 813-239-8069 | Fax:813-239-8447 | ||||||||
| Primary Practice Address | 5707 N 22ND ST TAMPA, FL 33610-4350 United States Phone: 813-239-8069 | Fax:813-239-8447 | ||||||||
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