Provider Demographics
NPI:1801037064
Name:LOFRISCO, BARBARA (PHD)
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:LOFRISCO
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 1:14499 N DALE MABRY HWY STE 164
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2049
Mailing Address - Country:US
Mailing Address - Phone:813-404-9215
Mailing Address - Fax:
Practice Address - Street 1:14499 N DALE MABRY HWY STE 164
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2049
Practice Address - Country:US
Practice Address - Phone:813-404-9215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-18
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2518106H00000X
FLMH10206101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health