Individual
REGINA CONKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3191 CLAY MANGUM LN, TAMPA, FL 33618-2501
(813) 264-3807
(813) 269-1372
Mailing address
608 SURREY LN, LUTZ, FL 33549-5682
(813) 264-3807
(813) 269-1372
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY4699
FL
Other
Enumeration date
06/25/2015
Last updated
06/25/2015
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