Individual
DANIELLE KONDRASHOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1897 SE MICCO DR, PORT SAINT LUCIE, FL 34952-8039
(772) 828-9065
Mailing address
1897 SE MICCO DR, PORT SAINT LUCIE, FL 34952-8039
(772) 828-9065
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
SW17198
FL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/15/2022
Last updated
04/02/2024
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