Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | SS1097 | FL |
NPI | 1003285503 |
---|---|
Provider Name | Ana Alonso |
First Address | Tampa, FL 33607-1622 |
Second Address | Tampa, FL 33629-8100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2015 |
Last Update Date | 15/09/2015 |