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Individual
MARTHA LUCIA FONSECA
Active
Individual
MARTHA LUCIA FONSECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
SW8027
FL
1041C0700X
Clinical Social Worker
Primary
SW8027
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001351300
—
FL
Enumeration date
09/25/2006
Last updated
07/26/2011
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