Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1033574686 |
---|---|
Provider Name | Erika Tornatore |
First Address | Winter Park, FL 32792 |
Second Address | Winter Park, FL 32792 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2015 |
Last Update Date | 28/12/2015 |