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General NPI Number Information
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NPI Number | 1134982259
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Entity Type | Individual
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Provider Name | KAITLYN FARMER RMHCI
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Gender | Female
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Dates
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Enumeration Date | 02/01/2024
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 16514 N DALE MABRY HWY
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City | TAMPA
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State | FL
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Zip | 33618-1325
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Country | US
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Telephone | 901-573-7975
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Fax |
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Provider Business Mailing Address
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Address Line | 3323 DIAMOND KNOT CIR
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City | TAMPA
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State | FL
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Zip | 33607-5821
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH25311
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License Number State | FL
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