Healthcare Provider Details

I. General information

NPI: 1003625237
Provider Name (Legal Business Name): SHEILA MOWBRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2025
Last Update Date: 01/02/2025
Certification Date: 12/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 N REO ST STE 150
TAMPA FL
33609-1031
US

IV. Provider business mailing address

31739 CABANA RYE AVE
SAN ANTONIO FL
33576-7189
US

V. Phone/Fax

Practice location:
  • Phone: 813-538-0385
  • Fax:
Mailing address:
  • Phone: 847-275-6615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: