Provider Demographics
NPI:1982169579
Name:NAQO, ERJOLA
Entity Type:Individual
Prefix:
First Name:ERJOLA
Middle Name:
Last Name:NAQO
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 1:705 ARCHERS BND
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-4462
Mailing Address - Country:US
Mailing Address - Phone:727-204-9521
Mailing Address - Fax:
Practice Address - Street 1:8550 ULMERTON RD
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-5358
Practice Address - Country:US
Practice Address - Phone:727-524-4464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health