Individual
STACI LORENZO SUITS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
623 OAK ST, GREEN COVE SPRINGS, FL 32043-4313
(904) 531-9752
Mailing address
2313 OLD PINE TRL, ORANGE PARK, FL 32003-4916
(904) 703-8498
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1454
FL
Other
Enumeration date
08/02/2019
Last updated
08/02/2019
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