Individual
MICHELLE LORA MENDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4360 DINNER LAKE BLVD, LAKE WALES, FL 33859-2129
(863) 232-7615
Mailing address
4360 DINNER LAKE BLVD, LAKE WALES, FL 33859-2129
(863) 232-7615
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
FL
Other
Enumeration date
11/02/2017
Last updated
07/29/2021
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