Individual
IVANA FREIRE COSTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2708 NE 14TH ST, SUITE 5, POMPANO BEACH, FL 33062-3565
(888) 880-9270
Mailing address
PO BOX 5963, LAKE WORTH, FL 33466-5963
(561) 201-2038
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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