Individual
CHRISTINE AGIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11120 S CROWN WAY STE 1, WELLINGTON, FL 33414-8718
(561) 790-1191
Mailing address
2151 W HILLSBORO BLVD, STE 203, DEERFIELD BEACH, FL 33442-1275
(954) 426-0410
(954) 596-4822
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW14909
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024572500
—
FL
Enumeration date
09/05/2018
Last updated
10/10/2019
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