Individual
MRS. JUDITH ESTHER DISLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16102 N FLORIDA AVE, LUTZ, FL 33549-6129
(813) 873-1936
(813) 873-8837
Mailing address
11110 CREEK HAVEN DR, RIVERVIEW, FL 33569-6206
(813) 842-8004
(813) 873-8837
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
02/03/2016
Last updated
02/03/2016
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