Organization
SWANDIVE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE CLARK (MANAGING MEMBER)
(813) 294-6931
Entity
Organization
Contact information
Practice address
4215 WATER OAKS LN, TAMPA, FL 33618-8633
(813) 294-6931
Mailing address
4215 WATER OAKS LN, TAMPA, FL 33618-8633
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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