Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003177866 |
---|---|
Provider Name | Ms. Mamie Lumpkin |
First Address | Maitland, FL 32751-7270 |
Second Address | Maitland, FL 32751-7270 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2012 |
Last Update Date | 08/03/2016 |