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1174037592
MARLENE Y SAMUELS
PORT ST LUCIE, FL
NPI
1174037592
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
261QD1600X Clinic/Center, Developmental Disabilities
Enumeration Date
2017-11-21
Last Update Date
2017-11-21
Business Address
MARLENE Y SAMUELS Med-waiver Provider
4241 SW HAGAPLAN ST
PORT ST LUCIE, FL 34953-6583
Phone number: 772-224-4466
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Mailing Address
MARLENE Y SAMUELS Med-waiver Provider
4241 SW HAGAPLAN ST
PORT ST LUCIE, FL 34953-6583
Phone number: 772-224-4466
Copy
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