Organization
BRENDA GONZALEZ CAMACHO LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA GONZALEZ CAMACHO LCSW (PRESIDENT)
(941) 613-1356
Entity
Organization
Contact information
Practice address
22099 ELMIRA BLVD, PORT CHARLOTTE, FL 33952-7018
(941) 613-1356
(941) 613-1591
Mailing address
22099 ELMIRA BLVD, PORT CHARLOTTE, FL 33952-7018
(941) 613-1356
(941) 613-1591
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW8837
FL
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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