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Individual

ANDREA KATHERIN VILLALBA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
518 PEACHTREE RD FL 32804, ORLANDO, FL 32804-6813
(407) 730-7983
Mailing address
2694 WINCHESTER CIR, EUSTIS, FL 32726-5234
(352) 431-1214

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
219147935
FL
Enumeration date
03/26/2022
Last updated
03/26/2022
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