Individual
MS. SHAVON DONASINA CORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
101 NEW YORK AVE, FORT WORTH, TX 76104-1558
(817) 255-7153
Mailing address
101 NEW YORK AVE, FORT WORTH, TX 76104-1558
(817) 255-7153
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
52367
TX
Other
Enumeration date
04/08/2013
Last updated
04/08/2013
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