Individual
ELAINE MICHELLE AYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15818 SW WARFIELD BLVD, INDIANTOWN, FL 34956-3513
(772) 597-0411
Mailing address
2251 SW CAPE COD DR, PORT ST LUCIE, FL 34953-4565
(772) 408-0053
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
900242545
—
FL
Enumeration date
07/08/2009
Last updated
07/08/2009
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