Provider Information for 1447919337
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DENISE MARIE LCPC, ATR-BC,NBC-HWC
Sex: Female
NPI: 1447919337
Last Updated: 2021-12-08
Certification Date: 2021-12-08
Certification Date: 2021-12-08
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1447919337 | ||||||||||||
| Enumeration Date | 2021-12-08 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 855 CENTRAL AVE UNIT 517 ST PETERSBURG, FL 33701-3661 United States Phone: 773-216-2193 | Fax: | ||||||||||||
| Primary Practice Address | 855 CENTRAL AVE UNIT 517 ST PETERSBURG, FL 33701-3661 United States Phone: 773-216-2193 | Fax: | ||||||||||||
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