Healthcare Provider Details

I. General information

NPI: 1376080689
Provider Name (Legal Business Name): OHIANA TORREALDAY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2017
Last Update Date: 01/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2706 W SAINT ISABEL ST
TAMPA FL
33607-6382
US

IV. Provider business mailing address

2706 W SAINT ISABEL ST
TAMPA FL
33607-6382
US

V. Phone/Fax

Practice location:
  • Phone: 888-666-3089
  • Fax: 888-666-9870
Mailing address:
  • Phone: 888-666-3089
  • Fax: 888-666-9870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY9301
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: