Individual
ESTEFANY SABRINA BOLOGNA NINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
13515 LAKE TERRACE LN, TAMPA, FL 33637-1003
(813) 505-6972
Mailing address
13515 LAKE TERRACE LN, TAMPA, FL 33637-1003
(813) 505-6972
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY10855
FL
103TC0700X
Clinical Psychologist
PY10855
FL
Other
Enumeration date
08/26/2020
Last updated
08/26/2020
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