Individual
BRENDA GONZALEZ CAMACHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
22099 ELMIRA BLVD, PORT CHARLOTTE, FL 33952-7018
(941) 613-1356
(941) 613-1591
Mailing address
PO BOX 496016, PORT CHARLOTTE, FL 33949-6016
(941) 613-1356
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW8837
FL
246R00000X
Pathology Technician
TN 36567
FL
Other
Enumeration date
03/07/2008
Last updated
09/25/2015
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