Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | MH19897 | FL |
Y | 101YM0800X | Mental Health Counselor | MH19897 | FL |
N | 101YP1600X | Pastoral Counselor | MH19897 | FL |
N | 101YP2500X | Professional Counselor | MH19897 | FL |
NPI | 1356002364 |
---|---|
Provider Name | Mary Ann Konstas |
First Address | Tampa, FL 33609-2243 |
Second Address | Tampa, FL 33609-2243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2022 |
Last Update Date | 03/01/2022 |