Individual
BERCELA KAY BANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
922 SW BAYA DR, LAKE CITY, FL 32025-4209
(386) 754-9005
(386) 754-9017
Mailing address
922 SW BAYA DR, LAKE CITY, FL 32025-4209
(386) 754-9005
(386) 754-9017
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW10363
FL
Other
Enumeration date
05/09/2013
Last updated
05/09/2013
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