Individual
MR. SLYVING DATON BOURDEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
365 WEKIVA SPRINGS RD STE 231, LONGWOOD, FL 32779-3690
(407) 470-5908
Mailing address
PO BOX 464, PLYMOUTH, FL 32768-0464
(407) 470-5908
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/08/2010
Last updated
09/29/2015
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