Individual
MRS. CAROLYN DIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1415 W OAK ST, #422288, KISSIMMEE, FL 34741-4025
(407) 761-8529
Mailing address
1415 W OAK ST, #422288, KISSIMMEE, FL 34741-4025
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW 13326
FL
Other
Enumeration date
04/27/2016
Last updated
04/27/2016
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