Healthcare Provider Details

I. General information

NPI: 1023747748
Provider Name (Legal Business Name): DONNA TUFF LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

11327 BRIGHTON KNOLL LOOP
RIVERVIEW FL
33579-2114
US

IV. Provider business mailing address

11327 BRIGHTON KNOLL LOOP
RIVERVIEW FL
33579-2114
US

V. Phone/Fax

Practice location:
  • Phone: 860-262-0625
  • Fax:
Mailing address:
  • Phone: 860-262-0625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH20880
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: