Individual
DR. JESSICA LINDSTADT VASSALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
13000 BRUCE B DOWNS BLVD, PSYCHOLOGY 116B, TAMPA, FL 33612-4745
(813) 972-2000
(813) 903-4814
Mailing address
13000 BRUCE B DOWNS BLVD, PSYCHOLOGY 116B, TAMPA, FL 33612-4745
(813) 972-2000
(813) 903-4814
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY7281
FL
103TC0700X
Clinical Psychologist
PY7281
FL
Other
Enumeration date
02/16/2006
Last updated
09/06/2012
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