Individual
MS. STEPHANIE ANNE PENG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CAP
Contact information
Practice address
5501 W WATERS AVE STE 404, TAMPA, FL 33634-1229
(813) 881-1000
Mailing address
5501 W WATERS AVE STE 404, TAMPA, FL 33634-1229
(813) 881-1000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5280
FL
101YM0800X
Mental Health Counselor
8995
FL
Other
Enumeration date
07/19/2012
Last updated
03/01/2013
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