Individual
MS. DELENE IACONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, RPT-S
Contact information
Practice address
8902 N DALE MABRY HWY, STE. 214, TAMPA, FL 33614-1588
(813) 857-6438
Mailing address
4018 W CARMEN ST, TAMPA, FL 33609-1205
(813) 857-6438
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6763
FL
1041C0700X
Clinical Social Worker
SW20144
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PO81261W6
—
TX
Enumeration date
06/20/2007
Last updated
07/08/2007
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