Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1568089761 |
---|---|
Provider Name | Chaira Zuriel Cancel Marquez |
First Address | Orlando, FL 32807-4714 |
Second Address | Palm Bay, FL 32905-5161 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2020 |
Last Update Date | 03/07/2020 |