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Individual

MRS. ILENE M. VINIKOOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DCSW, LMFT

Contact information

Practice address
420 SE 12TH ST, FORT LAUDERDALE, FL 33316-1902
(954) 522-7335
Mailing address
420 SE 12TH ST, FORT LAUDERDALE, FL 33316-1902
(954) 522-7335

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
SW104
FL
106H00000X
Marriage & Family Therapist
Primary
MT67
FL

Other

Enumeration date
05/16/2007
Last updated
08/08/2011
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