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General NPI Number Information
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NPI Number | 1619276557
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Entity Type | Organization
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Legal Business Name | AFFORDABLE BEHAVIORAL HEALTH SERVICES OF FL. INC.
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Dates
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Enumeration Date | 03/17/2011
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Last Update Date | 03/17/2011
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Provider Practice Location Address
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Address Line | 2630 W WATERS AVE SUITE B
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City | TAMPA
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State | FL
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Zip | 33614-2511
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Country | US
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Telephone | 813-935-4515
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Fax |
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Provider Business Mailing Address
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Address Line | 2630 W. WATERS AVE. SUITE B.
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City | TAMPA
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State | FL
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Zip | 33614
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Country | US
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Telephone | 813-935-4515
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. BONNIE LEE CHRISTENSEN
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Credential | LMHC
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Telephone | 813-935-4515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | MH10005
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License Number State | FL
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