Individual
MRS. MALISSA B WITHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
1515 MICHELIN CT, LUTZ, FL 33549-7533
(813) 949-8946
(813) 949-2926
Mailing address
1515 MICHELIN CT, LUTZ, FL 33549-7533
(813) 949-8946
(813) 948-1578
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH8079
FL
104100000X
Social Worker
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
767385000
—
FL
Enumeration date
12/13/2006
Last updated
01/04/2016
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