Individual
MS. ANNE DYNA DERIVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4161 CARMICHAEL AVE, BLDG 3300, SUITE 150, JACKSONVILLE, FL 32207-2353
(904) 396-8734
(904) 396-8759
Mailing address
1601 SW ARCHER RD, GAINESVILLE, FL 32608-1135
(904) 396-8734
(904) 396-8759
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10027
FL
Other
Enumeration date
10/16/2008
Last updated
10/17/2011
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