Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 12671 | FL |
NPI | 1003163064 |
---|---|
Provider Name | Miss Leighann Schaffer |
First Address | Tampa, FL 33614-3979 |
Second Address | Tampa, FL 33614-3979 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2012 |
Last Update Date | 28/03/2017 |