Individual
EDUARDO VILLAVICENCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
5338 JOCELYN LN, CHARLOTTE, NC 28269-6184
(305) 600-7569
Mailing address
5338 JOCELYN LN, CHARLOTTE, NC 28269-6184
(305) 600-7569
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P007292
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P007292
SOCIAL WORKER CERTIFICATION AND LICENSURE BOARD
NC
Enumeration date
06/04/2012
Last updated
06/04/2012
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