Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | SS1562 | FL |
NPI | 1063186583 |
---|---|
Provider Name | Cherice Greco |
First Address | Lutz, FL 33558-2740 |
Second Address | Tampa, FL 33609-3533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2021 |
Last Update Date | 07/08/2021 |