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Organization

FAMILY BUSINESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JUNE ROSE PH. D. (LCSW)
(239) 738-9114
Entity
Organization

Contact information

Practice address
923 DEL PRADO BLVD S, SUITE 205, CAPE CORAL, FL 33990-3652
(239) 738-9114
(239) 242-6389
Mailing address
923 DEL PRADO BLVD S, SUITE 205, CAPE CORAL, FL 33990-3652
(239) 738-9114
(239) 242-6389

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW1103
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SW1103
LICENSED CLINICAL SOCIAL WORKER
FL
Enumeration date
07/25/2008
Last updated
07/25/2008
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