Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1407347040 |
---|---|
Provider Name | Yarisel Marrero Torres |
First Address | Orange City, FL 32763-6762 |
Second Address | Kissimmee, FL 34741-4673 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2018 |
Last Update Date | 24/09/2018 |