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Individual

MISS CARLA DIANDRE GLASGOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8350 MULLIGAN CIR, PORT ST LUCIE, FL 34986-3280
(239) 641-4346
Mailing address
PO BOX 880591, PORT ST LUCIE, FL 34988-0591
(239) 641-4346

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
FL

Other

Enumeration date
11/26/2020
Last updated
01/07/2021
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