Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PY7395 | FL |
NPI | 1104026632 |
---|---|
Provider Name | Dr. Tamara Faith Viviano |
First Address | Ocala, FL 34474-4415 |
Second Address | Ocala, FL 34474-4415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2007 |
Last Update Date | 01/11/2009 |