Individual
MS. DAISY NICHOLE WIMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ITDS
Contact information
Practice address
137 PECKHAM ST SW, PORT CHARLOTTE, FL 33952
(239) 692-5432
Mailing address
137 PECKHAM ST SW, PORT CHARLOTTE, FL 33952-9136
(239) 692-5432
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
101Y00000X
FL
252Y00000X
Early Intervention Provider Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8117161
—
FL
Enumeration date
01/04/2007
Last updated
02/18/2019
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