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General NPI Number Information
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NPI Number | 1841648128
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Entity Type | Organization
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Legal Business Name | HOLISTIC SOLUTIONS COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 05/27/2016
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Last Update Date | 05/27/2016
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Provider Practice Location Address
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Address Line | 36739 STATE ROAD 52
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City | DADE CITY
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State | FL
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Zip | 33525-5101
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Country | US
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Telephone | 813-712-0188
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Fax |
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Provider Business Mailing Address
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Address Line | 36739 STATE ROAD 52
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City | DADE CITY
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State | FL
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Zip | 33525-5101
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Country | US
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Telephone | 813-712-0188
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | SEIDA REYES-PEREZ
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Credential | MA, LMHC
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Telephone | 813-712-0188
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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 | MH12740
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License Number State | FL
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