Organization
DR PSYCHOLOGIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA PENA MORALES (OWNER)
(813) 219-0152
Entity
Organization
Contact information
Practice address
26829 TANIC DR STE 101, WESLEY CHAPEL, FL 33544-4612
(813) 219-0152
Mailing address
2870 SATILLA LOOP, ODESSA, FL 33556-2736
(813) 219-0152
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
01/26/2022
Last updated
01/04/2023
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