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Individual

CASSEY R CHANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
4204 OKEECHOBEE RD, FORT PIERCE, FL 34947-5414
(772) 429-4564
Mailing address
4204 OKEECHOBEE RD, FORT PIERCE, FL 34947-5414
(772) 429-4564

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW9907
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
XXXXX7700
FL
Enumeration date
10/16/2011
Last updated
12/26/2013
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