Provider Demographics
NPI:1871283770
Name:TRAVER, TINA MILESE (RMHCI)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:MILESE
Last Name:TRAVER
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1603 HAVEN BND
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1139
Mailing Address - Country:US
Mailing Address - Phone:727-265-2803
Mailing Address - Fax:
Practice Address - Street 1:2240 TWELVE OAKS WAY
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-6970
Practice Address - Country:US
Practice Address - Phone:727-265-2803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-12
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH22406101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty