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General NPI Number Information
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NPI Number | 1356467344
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Entity Type | Individual
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Provider Name | VIRGINIA LEE EYERLY LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4425 PARK BLVD
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City | PINELLAS PARK
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State | FL
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Zip | 33781-3540
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Country | US
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Telephone | 727-547-0607
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Fax | 727-547-6752
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Provider Business Mailing Address
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Address Line | 826 CRENSHAW LAKE RD
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City | LUTZ
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State | FL
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Zip | 33548-8129
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Country | US
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Telephone | 813-909-7802
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Fax | 813-948-6325
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT2218
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License Number State | FL
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