Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 711 | FL |
NPI | 1013579861 |
---|---|
Provider Name | Eve Elise Wettstein |
First Address | Tallahassee, FL 32301-2506 |
Second Address | Tallahassee, FL 32303-5266 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2019 |
Last Update Date | 02/07/2019 |