Provider Demographics
NPI:1538306030
Name:ISAZA, MARIA HELENA (PHD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:HELENA
Last Name:ISAZA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 W SLIGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-4343
Mailing Address - Country:US
Mailing Address - Phone:813-932-3469
Mailing Address - Fax:813-933-8214
Practice Address - Street 1:2715 W SLIGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-4343
Practice Address - Country:US
Practice Address - Phone:813-932-3469
Practice Address - Fax:813-933-8214
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3735103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical