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1184273161
MAYRA IRIS PESANTE LOPEZ
TAMPA, FL
NPI
1184273161
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2019-09-11
Last Update Date
2019-09-11
Business Address
MAYRA IRIS PESANTE LOPEZ
10150 HIGHLANDS MANOR DRIVE SUITE 200
TAMPA, FL 33610
Phone number: 863-602-0698
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Mailing Address
MAYRA IRIS PESANTE LOPEZ
PO BOX 6553
LAKELAND, FL 33807-6553
Phone number: 863-602-0698
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