Individual
ADAIRIS BALSA ALFONSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LMHC
Contact information
Practice address
8816 HAMPDEN DR, TAMPA, FL 33626-2935
(813) 703-5759
Mailing address
8816 HAMPDEN DR, TAMPA, FL 33626-2935
(813) 703-5759
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH19268
FL
103K00000X
Behavior Analyst
Primary
1-25-80395
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110637800
—
FL
Enumeration date
07/20/2021
Last updated
04/11/2025
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