Organization Name: | IREBOOT, LLC |
NPI Number: | 1518311398 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CYNTHIA CITRON (OWNER) |
Mailing Address: | 4511 N Himes Ave Ste 200 Tampa |
State: | FL US |
Postal Code: | 336147085 |
Phone Number: | 8134227609 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2016 |
NPI Last Update Date: | 04/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | MH12380 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |