Individual
LAKECIA CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1605 E 32ND AVE, TAMPA, FL 33610-8129
(813) 760-3886
Mailing address
PO BOX 16802, TAMPA, FL 33687-6802
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/03/2020
Last updated
07/03/2020
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