Individual
LISA GRAYCE SCHIAVONI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 NW 33RD CT, GAINESVILLE, FL 32607-2552
(352) 374-7155
Mailing address
4019 NW 34TH TER, GAINESVILLE, FL 32605-1498
(352) 374-7155
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
SS315
FL
222Q00000X
Developmental Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81555900
—
FL
Enumeration date
05/23/2007
Last updated
06/11/2019
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