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Organization

GINA V EATON, LCSW, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GINA V EATON LCSW (OWNER/PRESIDENT)
(954) 862-1736
Entity
Organization

Contact information

Practice address
12555 ORANGE DR, SUITE 215, DAVIE, FL 33330-4304
(954) 862-1736
(954) 862-1738
Mailing address
12555 ORANGE DR, SUITE 215, DAVIE, FL 33330-4304
(954) 862-1736
(954) 862-1738

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
SW 3884
FL

Other

Enumeration date
10/23/2014
Last updated
10/23/2014
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