Individual
DITMARA TAMAYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11760 W SAMPLE RD STE 101, CORAL SPRINGS, FL 33065-3199
(954) 345-5644
(954) 345-5683
Mailing address
11760 W SAMPLE RD STE 101, CORAL SPRINGS, FL 33065-3199
(954) 345-5644
(954) 345-5683
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
SW6705
FL
1041C0700X
Clinical Social Worker
Primary
SW6705
FL
Other
Enumeration date
09/19/2007
Last updated
06/27/2019
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