Provider Information for 1770960569
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Ms. WAFA VIVIAN ALKOKA L.M.H.C
Sex: Female
NPI: 1770960569
Last Updated: 2018-01-05
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1770960569 | ||||||||
| Enumeration Date | 2015-04-30 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 20435 NEEDLETREE DRIVE TAMPA, FL 33647 United States Phone: 352-410-9099 | Fax: | ||||||||
| Primary Practice Address | 3200 SW 34TH AVE SUITE 203 OCALA, FL 34474-7456 United States Phone: 352-624-2137 | Fax: | ||||||||
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