Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | SW 9100 | FL |
NPI | 1003094947 |
---|---|
Provider Name | Kathryn Mccormic |
First Address | Palm City, FL 34990-5090 |
Second Address | Palm City, FL 34990-5090 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2008 |
Last Update Date | 15/08/2013 |