Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003451352 |
---|---|
Provider Name | Octivier Sweeting |
First Address | Davie, FL 33317-7416 |
Second Address | Miami, FL 33169-6306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2019 |
Last Update Date | 11/11/2019 |