Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | SW12243 | FL |
NPI | 1003218769 |
---|---|
Provider Name | Sarah Shirina |
First Address | Brooksville, FL 34613-6005 |
Second Address | Brooksville, FL 34613-6005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2014 |
Last Update Date | 24/09/2014 |