Individual
MRS. CATHLEEN ADIVA MAURICETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
280 1ST ST BLDG 23, HOLLOMAN AFB, NM 88330-8273
(575) 572-5676
Mailing address
280 1ST ST BLDG 23, HOLLOMAN AFB, NM 88330-8273
(575) 572-5676
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW15987
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ISW9488
REGISTERED CLINICAL SOCIAL WORK INTERN
FL
Enumeration date
10/16/2017
Last updated
02/09/2023
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