JEAN ELYSE DIEVENDORF

PALM BAY, FL
NPI1184173981
Former NameJEAN ELYSE GAUTREAUX
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy104100000X Social Worker
Additional Taxonomies101YM0800X Counselor, Mental Health
(Licence: FL  SW16874)
1041C0700X Social Worker, Clinical
(Licence: FL  SW16874)
Enumeration Date2016-09-22
Last Update Date2024-02-14
Business Address
JEAN ELYSE DIEVENDORF
6050 BABCOCK ST SE STE 32
PALM BAY, FL 32909-4205
Phone number: 321-684-8265
Mailing Address
JEAN ELYSE DIEVENDORF
2257 WHITESIDE AVE SE
PALM BAY, FL 32909-6044
Phone number: 321-405-2583