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Organization

INNOVATIVE COUNSELING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEFFREY BRIAN SMIALEK LMHC (MANAGING MEMBER)
(813) 838-3074
Entity
Organization

Contact information

Practice address
25251 SR 54,PMB 205, WESLEY CHAPEL, FL 33544
(813) 322-3850
Mailing address
7251 SR 54,PMB 205, WESLEY CHAPEL, FL 33544
(813) 322-3850

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
MH9288
FL

Other

Enumeration date
11/27/2012
Last updated
11/27/2012
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