Individual
KEZIAH CELINA BUENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4009 DEERWOOD CIR, PACE, FL 32571-1108
(448) 201-2604
Mailing address
4009 DEERWOOD CIR, PACE, FL 32571-1108
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
B500503979490
FL
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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