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Individual

MS. LACANDICE TAMEKA BRINSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
502 NW SAGAMORE TER, PORT ST LUCIE, FL 34983-8665
(772) 940-4046
Mailing address
502 NW SAGAMORE TER, PORT ST LUCIE, FL 34983-8665
(772) 940-4046

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary

Other

Enumeration date
10/07/2024
Last updated
10/07/2024
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