Individual
AISHAH BOODRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
10139 BEACH PORT DR, WINTER GARDEN, FL 34787-4413
(618) 472-8964
(404) 487-8907
Mailing address
10139 BEACH PORT DR, WINTER GARDEN, FL 34787-4413
(678) 472-8964
(404) 487-8907
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CSW004935
GA
1041C0700X
Clinical Social Worker
Primary
SW16655
FL
Other
Enumeration date
05/07/2015
Last updated
06/26/2020
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