MEDICARE: MARY ELIZABETH MEEKER M.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	5117	FL

General Provider Information

NPI Number	:	1174791024
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ELIZABETH MEEKER M.A.

Provider Business Mailing Address
First Line	:	2504 W AZEELE ST
Second Line	:	SUITE D
City	:	TAMPA
State	:	FL
Zip	:	33609-3575
Country	:	US
Telephone Number	:	813-362-6471
Fax Number	:

Provider Business Practice Location Address
First Line	:	2504 W AZEELE ST
Second Line	:	SUITE D
City	:	TAMPA
State	:	FL
Zip	:	33609-3575
Country	:	US
Telephone Number	:	813-362-6471
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2008
Last Update Date	:	02/13/2008

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