Agency Of Change
Social Worker, Clinical in Fort Lauderdale, FL. Organization (NPI-2).
NPI number1407153885
StatusActive
Last updated in NPPESFeb 20, 2011
Details
- NPI
- 1407153885
- Entity type
- Organization (NPI-2)
- Legal business name
- Agency Of Change
- Organization subpart
- No
- Enumeration date
- Feb 20, 2011
- Last updated
- Feb 20, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | SW8327 | FL | Yes |
Practice location
900 Ne 18th Ave1207
Fort Lauderdale, FL 33304-3063
Phone 954-524-6861
Mailing address
900 Ne 18th Ave1207
Fort Lauderdale, FL 33304-3063
Phone 954-524-6861
Authorized official
Melanie Donohue
President
9544655142
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