Individual
MODESTA SANTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 272-2878
Mailing address
5707 N 22ND ST, TAMPA, FL 33610-4350
(813) 272-2878
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/16/2008
Last updated
12/16/2008
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