Individual
MS. CHARISSE CANNADY FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1503 CAYMAN WAY, UNIT E-1, COCONUT CREEK, FL 33066-1435
(352) 870-4675
Mailing address
1503 CAYMAN WAY, UNIT E-1, COCONUT CREEK, FL 33066-1435
(352) 870-4675
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW9262
FL
Other
Enumeration date
03/26/2021
Last updated
03/26/2021
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