Provider Information for 1174123103
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CLAIRE BAZILE LMHC
Sex: Female
NPI: 1174123103
Last Updated: 2020-10-28
Certification Date: 2020-10-28
Certification Date: 2020-10-28
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1174123103 | ||||||||
| Enumeration Date | 2020-10-28 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 9725 SHAMOKIN LN PORT RICHEY, FL 34668-3991 United States Phone: 727-564-3759 | Fax: | ||||||||
| Primary Practice Address | 9725 SHAMOKIN LN PORT RICHEY, FL 34668-3991 United States Phone: 727-564-3759 | Fax: | ||||||||
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