Facts
- Status
- A
- Credential
- LCSW
- Type
- Individual
- Enumeration date
- 2013-09-10
- Last updated
- 2019-06-13
Licenses
- License FL
- SW11750
Location
- Practice location
- 725 N 12TH AVE BLDG B
- City
- ARCADIA FL
- Postal code
- 34266
- Phone
- 863-494-1242
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.