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General NPI Number Information
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NPI Number | 1194291849
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Entity Type | Individual
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Provider Name | ANGELA ORTIZ CANQUE-KAPLAN LMHC
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Gender | Female
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Dates
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Enumeration Date | 10/21/2018
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Last Update Date | 10/21/2018
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Provider Practice Location Address
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Address Line | 300 E MADISON ST STE 201
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City | TAMPA
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State | FL
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Zip | 33602-4813
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Country | US
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Telephone | 813-609-6946
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Fax | 813-609-6947
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Provider Business Mailing Address
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Address Line | 11213 CEDAR HOLLOW LN
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City | TAMPA
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State | FL
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Zip | 33618-8703
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Country | US
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Telephone | 941-661-1211
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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 | MH16391
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License Number State | FL
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