Individual
MR. DALE ASHBY ELZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
6420 W NEWBERRY RD STE 100, GAINESVILLE, FL 32605-6622
(352) 332-3900
(352) 332-5009
Mailing address
4371 VERONICA S SHOEMAKER BLVD, ATTN CREDENTIALING, FORT MYERS, FL 33916-2216
(239) 274-8200
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9003
FL
1041C0700X
Clinical Social Worker
CSW003365
GA
Other
Enumeration date
09/01/2006
Last updated
03/13/2020
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