Individual
MARIETHA DESTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
211 LITHIA PINECREST RD, BRANDON, FL 33511-5307
(813) 720-5191
Mailing address
211 LITHIA PINECREST RD, BRANDON, FL 33511-5307
(813) 720-5191
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MT2998
FL
101YS0200X
School Counselor
—
—
106H00000X
Marriage & Family Therapist
MT2998
FL
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
03/13/2011
Last updated
03/09/2015
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