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Individual

AIDA ASON VIVANCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8175 NW 12TH ST STE 119, DORAL, FL 33126-1828
(786) 362-5981
Mailing address
8175 NW 12TH ST STE 119, DORAL, FL 33126-1828
(786) 362-5981

Taxonomy

Speciality
Code
Description
License number
State
103TH0004X
Health Psychologist
Primary
IMH7588
FL

Other

Enumeration date
06/19/2017
Last updated
08/12/2024
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