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Individual

MRS. TRACENA ANNETTE STUDMIRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
HOME HEALTH

Contact information

Practice address
351 DELANCEY DR, DAVENPORT, FL 33837-7644
(321) 682-6819
(407) 870-9605
Mailing address
12513 WISCONSIN WOODS LN, ORLANDO, FL 32824-9022
(321) 682-6819

Taxonomy

Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
Primary
005538400
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005538400
FL
Enumeration date
06/25/2014
Last updated
10/30/2015
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