Individual
EDWIN F. SAUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 707-7240
Mailing address
PO BOX 3834, PLANT CITY, FL 33563-0014
(813) 441-4699
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
—
—
103T00000X
Psychologist
Primary
004290-1
NY
103TA0400X
Addiction (Substance Use Disorder) Psychologist
004290-1
NY
103TC1900X
Counseling Psychologist
004290-1
NY
Other
Enumeration date
03/29/2007
Last updated
09/18/2008
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