Individual
MAVILA RACHELL DUMANOIR-GARCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
7620 LAKE UNDERHILL RD, ORLANDO, FL 32822-8223
(321) 235-0692
(321) 235-0694
Mailing address
3564 AVALON PARK BLVD E STE 1, ORLANDO, FL 32828-7365
(321) 235-0692
(321) 235-0694
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SW15936
STATE LICENSE
FL
Enumeration date
10/04/2019
Last updated
10/04/2019
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