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General NPI Number Information
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NPI Number | 1770280901
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Entity Type | Individual
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Provider Name | REBECCA TULLOS DARGIS ED.S.
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Gender | Female
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Dates
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Enumeration Date | 02/08/2023
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 2479 ALOMA AVE.
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City | WINTER PARK
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State | FL
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Zip | 32792
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Country | US
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Telephone | 407-252-3407
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Fax |
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Provider Business Mailing Address
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Address Line | 12556 CROWN POINT CIRCLE
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City | CLERMONT
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State | FL
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Zip | 34711
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Country | US
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Telephone | 407-252-3407
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 55834
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License Number State | FL
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