| Lisa M. Petrica-moser, Ph.d. Inc. | |
|
2727 W Dr Martin Luther King Jr Blvd Tampa FL 33607-6383 | |
| (727) 244-5975 | |
| Not Available |
| Full Name | Lisa M. Petrica-moser, Ph.d. Inc. |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 2727 W Dr Martin Luther King Jr Blvd, Tampa, Florida |
| Authorized Official Name and Position | Lisa Mari Moser (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 7272445975 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa M. Petrica-moser, Ph.d. Inc. 1790 Captiva Dr Oldsmar FL 34677-5220 Ph: (727) 244-5975 | Lisa M. Petrica-moser, Ph.d. Inc. 2727 W Dr Martin Luther King Jr Blvd Tampa FL 33607-6383 Ph: (727) 244-5975 |
| NPI Number | 1104362979 |
|---|---|
| Provider Enumeration Date | 01/17/2017 |
| Last Update Date | 01/17/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104362979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | PY5976 (Florida) | Primary |
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