Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | MH12745 | FL |
N | 101YS0200X | School Counselor | MH12745 | FL |
NPI | 1033532551 |
---|---|
Provider Name | Heather Maturo |
First Address | St Petersburg, FL 33716-2918 |
Second Address | St Petersburg, FL 33716-2918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2014 |
Last Update Date | 17/03/2018 |