Provider Demographics
NPI:1811295017
Name:CLAUBERG, MAYRA PITA
Entity type:Individual
Prefix:MRS
First Name:MAYRA
Middle Name:PITA
Last Name:CLAUBERG
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 1:911 CORNELIUS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-1715
Mailing Address - Country:US
Mailing Address - Phone:813-236-6242
Mailing Address - Fax:813-236-6242
Practice Address - Street 1:911 CORNELIUS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1715
Practice Address - Country:US
Practice Address - Phone:813-236-6242
Practice Address - Fax:813-236-6242
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-11
Last Update Date:2011-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor