| NPI | 1699077891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE M DIGERONIMO Provider 321-230-3023 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW2181) |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2024-11-18 |