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Maisy Lee Phravoraxay, MSW

Counselor, Mental Health in Clearwater, FL. Individual provider (NPI-1).

NPI number1104550482
StatusActive
Last updated in NPPESAug 1, 2022

Details

NPI
1104550482
Entity type
Individual (NPI-1)
Name
Maisy Lee Phravoraxay
Credential
MSW
Sex
Female
Sole proprietor
Yes
Enumeration date
Jul 13, 2022
Certification date
Aug 1, 2022
Last updated
Aug 1, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
101YM0800X Counselor, Mental Health29219MNYes

Practice location

2188 58th St N
Clearwater, FL 33760-3112

Phone 727-327-7656

Mailing address

Po Box 10970
Saint Petersburg, FL 33733-0970

Phone 727-327-7656

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