Individual
TATIANA LUCES-RIVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1573 W FAIRBANKS AVE STE 220, WINTER PARK, FL 32789-4679
(407) 303-7991
(407) 303-7803
Mailing address
6252 ARALIA IVY LN, WINTER GARDEN, FL 34787-9536
(305) 450-4328
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY11381
FL
103T00000X
Psychologist
—
—
Other
Enumeration date
09/14/2021
Last updated
09/23/2022
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