Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CAP 1760 | FL |
Y | 1041C0700X | Clinical Social Worker | SW 4665 | FL |
NPI | 1003058314 |
---|---|
Provider Name | Libby G Royer |
First Address | West Palm Beach, FL 33405-1666 |
Second Address | West Palm Beach, FL 33405-1666 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2009 |
Last Update Date | 01/04/2009 |