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Individual

LISA FEDEWA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
259 BILL FRANCE BLVD, SUITE 200, DAYTONA BEACH, FL 32114-1316
(904) 586-6560
Mailing address
1955 LEAP FROG LN, MIDDLEBURG, FL 32068-9095

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
11/12/2012
Last updated
08/05/2014
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  • Eligibility checks
  • EDI platform