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General NPI Number Information
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NPI Number | 1932990611
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Entity Type | Individual
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Provider Name | GALIA NISSIM
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Gender | Female
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 5701 N FLORIDA AVE
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City | TAMPA
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State | FL
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Zip | 33604-6913
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Country | US
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Telephone | 718-781-7341
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Fax |
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Provider Business Mailing Address
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Address Line | 2825 W FOUNTAIN BLVD
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City | TAMPA
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State | FL
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Zip | 33609-4011
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Country | US
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Telephone | 718-781-7341
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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 | IMH23331
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License Number State | FL
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