Individual
MISS ELYSSA LIZ AREVALO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4902 EISENHOWER BLVD, SUITE 315, TAMPA, FL 33634-6310
(787) 633-7290
Mailing address
PO BOX 260331, TAMPA, FL 33685-0331
(787) 633-7290
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
009228
CT
1041C0700X
Clinical Social Worker
Primary
SW13641
FL
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/28/2015
Last updated
08/25/2016
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