Individual
ISMARY OLIVA RAXACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TCM SUPERVISOR
Contact information
Practice address
3908 W 12TH AVE, HIALEAH, FL 33012-4105
(305) 400-8904
(786) 703-3924
Mailing address
3908 W 12TH AVE, HIALEAH, FL 33012-4105
(305) 400-8904
(786) 703-3924
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
04/25/2023
Last updated
06/14/2023
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