Provider Demographics
NPI:1255895736
Name:GUZMAN, CELINES
Entity type:Individual
Prefix:
First Name:CELINES
Middle Name:
Last Name:GUZMAN
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 1:5102 ROSEGREEN CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-4879
Mailing Address - Country:US
Mailing Address - Phone:813-508-3306
Mailing Address - Fax:
Practice Address - Street 1:2901 W SAINT ISABEL ST STE A1
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6350
Practice Address - Country:US
Practice Address - Phone:888-666-3089
Practice Address - Fax:888-666-9870
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health