Healthcare Provider Details

I. General information

NPI: 1801517214
Provider Name (Legal Business Name): ARIELLE RAYNA WAJSMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 66TH ST N STE 205
PINELLAS PARK FL
33781-2101
US

IV. Provider business mailing address

2331 HANSEN CT
TALLAHASSEE FL
32301-4859
US

V. Phone/Fax

Practice location:
  • Phone: 727-214-2740
  • Fax:
Mailing address:
  • Phone: 850-320-6555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberIMH29668
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: