Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | SW12113 | FL |
NPI | 1003206640 |
---|---|
Provider Name | Christopher Santini |
First Address | Fort Myers, FL 33919-1609 |
Second Address | Fort Myers, FL 33919-1609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2015 |
Last Update Date | 04/02/2015 |