Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1740633544 |
---|---|
Provider Name | Pierre Jean Duvelsaint |
First Address | Orlando, FL 32805-2285 |
Second Address | Orlando, FL 32805-2285 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2016 |
Last Update Date | 15/07/2016 |