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Individual

LYNDIAN MARTA CHACON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPS

Contact information

Practice address
12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
(813) 977-8700
Mailing address
17823 MORNINGHIGH DR, LUTZ, FL 33549-5525
(813) 948-6075

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary

Other

Enumeration date
05/01/2014
Last updated
05/01/2014
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