Healthcare Provider Details

I. General information

NPI: 1477698207
Provider Name (Legal Business Name): PATRICIA BEXLEY M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5707 N 22ND ST
TAMPA FL
33610-4350
US

IV. Provider business mailing address

6105 E LIBERTY AVE
TAMPA FL
33617-3120
US

V. Phone/Fax

Practice location:
  • Phone: 813-272-2878
  • Fax: 813-272-3766
Mailing address:
  • Phone: 813-868-0406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: