Organization
GWEN KOTLER LCSW
Active
Organization
GWEN KOTLER LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWEN KOTLER (CLINICAL SOCIAL WORKER)
(386) 334-8430
Entity
Organization
Contact information
Practice address
570 MEMORIAL CIR STE 150, ORMOND BEACH, FL 32174-5062
(386) 334-8430
Mailing address
27 BLACK PINE WAY, ORMOND BEACH, FL 32174-1863
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
SW7398
FL
Other
Enumeration date
01/14/2009
Last updated
01/14/2009
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