Individual
ANGIE BACON LOPRESTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ITDS
Contact information
Practice address
1 OCEAN TRACE RD UNIT 112, SAINT AUGUSTINE, FL 32080-6977
(251) 605-5834
Mailing address
1 OCEAN TRACE RD UNIT 112, SAINT AUGUSTINE, FL 32080-6977
(251) 605-5834
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
FL
Other
Enumeration date
04/21/2021
Last updated
04/21/2021
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