Provider Demographics
NPI:1992313720
Name:ZUBIA-DEJONG, VERONICA (RMHCI)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:ZUBIA-DEJONG
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 1:14499 N DALE MABRY HWY STE 164
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2049
Mailing Address - Country:US
Mailing Address - Phone:813-625-0139
Mailing Address - Fax:
Practice Address - Street 1:14499 N DALE MABRY HWY STE 164
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2049
Practice Address - Country:US
Practice Address - Phone:813-625-0139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IMH18965101YM0800X
FLIMH18965101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty