Individual
KANILINA CLERGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
867 W BLOOMINGDALE AVE # 6971, BRANDON, FL 33511-7701
(863) 313-0340
Mailing address
867 W BLOOMINGDALE AVE # 6971, BRANDON, FL 33511-7701
(863) 313-0340
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MT4165
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/26/2012
Last updated
06/30/2022
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