Individual
CORAZAN AQUINO ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4100 INVERRARY DR, LAUDERHILL, FL 33319-4510
(616) 856-0636
Mailing address
4100 INVERRARY DR, LAUDERHILL, FL 33319-4510
(616) 856-0636
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW21721
FL
Other
Enumeration date
07/05/2023
Last updated
04/28/2024
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