Individual
MRS. CARRIE KYOKO LACAYO-BENTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
88 RIBERIA ST, SUITE 150, ST AUGUSTINE, FL 32084-3300
(904) 201-9533
Mailing address
88 RIBERIA ST, SUITE 150, ST AUGUSTINE, FL 32084-3300
(904) 201-9533
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW 10201
FL
Other
Enumeration date
01/26/2012
Last updated
12/04/2014
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