Individual
BETSIE CIESLAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3850 E STATE ROAD 64, BRADENTON, FL 34208-9040
(941) 748-2697
Mailing address
1726 CASTLE ROCK RD, TAMPA, FL 33612-7672
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
ISW19761
FL
Other
Enumeration date
02/26/2024
Last updated
06/18/2024
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