Individual
BRENA DESOUZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3491 GANDY BLVD N STE 201, PINELLAS PARK, FL 33781-2654
(727) 547-0607
Mailing address
115 112TH AVE NE APT 323, SAINT PETERSBURG, FL 33716-3255
(312) 933-6011
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/01/2021
Last updated
06/01/2021
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