Individual
LAETITIA B FERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS PSY
Contact information
Practice address
1945 22ND AVE, VERO BEACH, FL 32960-3083
(772) 257-5264
(772) 257-5265
Mailing address
1945 22ND AVE, VERO BEACH, FL 32960-3083
(772) 257-5264
(772) 257-5265
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
IMH9028
FL
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002649800
—
FL
Enumeration date
09/10/2010
Last updated
07/26/2011
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