Individual
MISS COLLEEN MARIAH LAMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
3333 W BEARSS AVE, TAMPA, FL 33618-2100
(813) 269-4879
(813) 433-5561
Mailing address
13908 SEAFORTH MANOR WAY, TAMPA, FL 33613-1925
(219) 241-3235
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-20949
—
235Z00000X
Speech-Language Pathologist
SA12561
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007181700
—
FL
Enumeration date
09/17/2012
Last updated
08/12/2024
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