Individual
ALEA ELIZABETH GOTTERUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6951 PISTOL RANGE RD, TAMPA, FL 33635-9601
(813) 696-0700
Mailing address
1436 SEAGULL DR APT 105, PALM HARBOR, FL 34685-3464
(757) 277-8738
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/14/2022
Last updated
02/14/2022
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