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Contact Information

VIVIAN A LORETDEMOLA, PhD
3599 W. LAKE MARY BLVD, SUITE B2
LAKE MARY, FL32746
 Phone: 386-675-7467
 Fax: 386-256-3665
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for VIVIAN A LORETDEMOLA · (Female)

NPI # 1891201638
Status Active
Credentials PhD
Entity Individual
Enumeration date 12/15/2017
Last updated 12/15/2017 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # PY5437
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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