Individual
MARIA ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1479 47TH AVE NE, ST PETERSBURG, FL 33703-4113
(727) 545-6477
Mailing address
1479 47TH AVE NE, ST PETERSBURG, FL 33703-4113
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MH0004115
FL
Other
Enumeration date
03/07/2007
Last updated
07/08/2007
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