Individual
MRS. SALLY TERESA RAIFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
322 W BEARSS AVE, TAMPA, FL 33613-1228
(813) 285-4480
Mailing address
10305 NEWPORT CIR, TAMPA, FL 33612-6527
(702) 477-5757
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT3667
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01062
LICENSE
NV
Enumeration date
05/03/2007
Last updated
10/28/2024
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