Individual
ROXANNE CAVATAIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1403 43RD AVE, GULFPORT, MS 39501
(228) 861-5260
(228) 241-0326
Mailing address
PO BOX 4456, BAY SAINT LOUIS, MS 39521-4456
(228) 861-5260
(228) 241-0326
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C3900
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117751
—
MS
Enumeration date
09/22/2006
Last updated
12/05/2018
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