Individual
MARISA MANGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13000 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4745
(813) 972-2000
Mailing address
9717 LAKE JASMINE DR APT 9717, TAMPA, FL 33626-1873
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PY11724
FL
Other
Enumeration date
12/19/2022
Last updated
12/19/2022
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