Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | SW-0004116 | FL |
NPI | 1104956978 |
---|---|
Provider Name | Mr. Nicholas Peter Terranova |
First Address | Tampa, FL 33609 |
Second Address | Tampa, FL 33609-3002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 08/07/2007 |