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Individual

BRENT JASON CONCKLIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMHC

Contact information

Practice address
2100 ASHLEY OAKS CIR, WESLEY CHAPEL, FL 33544-6416
(813) 308-9808
Mailing address
2100 ASHLEY OAKS CIR, WESLEY CHAPEL, FL 33544-6416
(813) 308-9808

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH6097
FL

Other

Enumeration date
10/28/2008
Last updated
02/05/2014
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