Individual
INGRID DIANNA CASTELBLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.S.
Contact information
Practice address
11735 SW 103RD AVE, MIAMI, FL 33176-4000
(305) 720-7680
Mailing address
11735 SW 103RD AVE, MIAMI, FL 33176-4000
(305) 720-7680
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
SS770
FL
Other
Enumeration date
04/20/2021
Last updated
04/20/2021
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