Organization
HEALTHY LIFESTYLES TAMPA BAY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS G QUINLAN PSY.D (OWNER)
(727) 906-6185
Entity
Organization
Contact information
Practice address
8479 DR MARTIN LUTHER KING JR ST N, ST PETERSBURG, FL 33702
(727) 906-6185
(866) 352-2359
Mailing address
8479 DR MARTIN LUTHER KING JR ST N, ST PETERSBURG, FL 33702-3503
(727) 906-6185
(866) 352-2359
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PY7593
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PY7593
PROFESSIONAL LICENSE
FL
Enumeration date
01/17/2018
Last updated
06/26/2018
Update your record
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