Provider Demographics
NPI:1366836074
Name:GALIN, MORA
Entity Type:Individual
Prefix:
First Name:MORA
Middle Name:
Last Name:GALIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 MILANO CIR APT 107
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-7160
Mailing Address - Country:US
Mailing Address - Phone:813-850-9959
Mailing Address - Fax:
Practice Address - Street 1:925 MILANO CIR APT 107
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-7160
Practice Address - Country:US
Practice Address - Phone:813-850-9959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health