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General NPI Number Information
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NPI Number | 1659042117
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Entity Type | Organization
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Legal Business Name | PROFICIENT INTEGRATION MENTAL HEALTH LLC.
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Dates
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Enumeration Date | 09/24/2021
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 911 S PARSONS AVE STE D
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City | BRANDON
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State | FL
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Zip | 33511-6042
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Country | US
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Telephone | 813-922-8240
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Fax | 855-941-2554
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Provider Business Mailing Address
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Address Line | 14819 CRESCENT ROCK DR
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City | WIMAUMA
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State | FL
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Zip | 33598-6196
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Country | US
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Telephone | 469-216-4017
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CAMILLE Y TURNER- SNAGG
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Credential | PMHNP-BC
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Telephone | 469-216-4017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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