Individual
TANISHA GRACENA JOSEPH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2260 TERRA COTTA CV APT 208, LAND O LAKES, FL 34639-2870
(516) 322-6040
Mailing address
2260 TERRA COTTA CV APT 208, LAND O LAKES, FL 34639-2870
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/04/2019
Last updated
04/04/2019
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