Provider Information for 1497173785
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Ms. MARISSA GERACI LMHC
Sex: Female
NPI: 1497173785
Last Updated: 2019-10-01
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1497173785 | ||||||||||||
| Enumeration Date | 2014-04-03 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 2401 BAYSHORE BLVD UNIT 412 TAMPA, FL 33629 United States Phone: 813-675-7749 | Fax:813-867-3220 | ||||||||||||
| Primary Practice Address | 730 S STERLING AVE SUITE 204 TAMPA, FL 33609 United States Phone: 813-675-7749 | Fax:813-867-3220 | ||||||||||||
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