Individual
IVELISSE VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
618 N MAIN ST, KISSIMMEE, FL 34744-5262
(407) 343-6006
Mailing address
2107 DRIVE WAY, KISSIMMEE, FL 34746-3899
(787) 671-7288
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
PR
Other
Enumeration date
05/09/2022
Last updated
05/09/2022
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