Individual
MISS DIEUNANE FORMUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1580 NW 10TH AVE, MIAMI, FL 33136-1013
(305) 243-4546
Mailing address
1580 NW 10TH AVE, MIAMI, FL 33136-1013
(305) 243-4546
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW8668
FL
Other
Enumeration date
03/22/2009
Last updated
11/12/2014
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