Shelley Dereu, LCSW
Social Worker, Clinical in Port Charlotte, FL. Individual provider (NPI-1).
NPI number1982932141
StatusActive
Last updated in NPPESNov 30, 2009
Details
- NPI
- 1982932141
- Entity type
- Individual (NPI-1)
- Name
- Shelley Dereu
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 30, 2009
- Last updated
- Nov 30, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | SW 7311 | FL | Yes |
Practice location
4161 Tamiami TrlSuite 401
Port Charlotte, FL 33952-9204
Phone 239-980-4156 · Fax 941-623-1215
Mailing address
4161 Tamiami TrlSuite 401
Port Charlotte, FL 33952-9204
Fax 941-623-1215
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