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General NPI Number Information
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NPI Number | 1417548728
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Entity Type | Organization
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Legal Business Name | INSCAPE HEALTH GROUP LLC
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Dates
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Enumeration Date | 01/29/2021
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 1970 MICHIGAN AVE BLDG E
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City | COCOA
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State | FL
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Zip | 32922-5723
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Country | US
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Telephone | 407-209-7428
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Fax |
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Provider Business Mailing Address
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Address Line | 1970 MICHIGAN AVE BLDG E
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City | COCOA
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State | FL
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Zip | 32922-5723
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Country | US
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Telephone | 407-209-7428
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL; PARTNER/OWNER
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Name | DR. TAMIKA SELENA HAYNES ROBINSON
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Credential | PHD
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Telephone | 407-209-7428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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