| Dominica J. Debrauwere Lcsw, Dcsw, Inc. | |
|
4284 Kelson Ave. Marianna FL 32446-6399 | |
| (850) 443-9801 | |
| (850) 526-3349 |
| Full Name | Dominica J. Debrauwere Lcsw, Dcsw, Inc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 4284 Kelson Ave., Marianna, Florida |
| Authorized Official Name and Position | Dominica J. Debrauwere (THERAPIST/PRESIDENT) |
| Authorized Official Contact | 8504439801 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dominica J. Debrauwere Lcsw, Dcsw, Inc. 2584 Governors Ct Marianna FL 32446-6399 Ph: (850) 443-9801 | Dominica J. Debrauwere Lcsw, Dcsw, Inc. 4284 Kelson Ave. Marianna FL 32446-6399 Ph: (850) 443-9801 |
| NPI Number | 1194080895 |
|---|---|
| Provider Enumeration Date | 07/09/2012 |
| Last Update Date | 07/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194080895 | NPI | - | NPPES |
| 1356423537 | Other | FL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW 3307 (Florida) | Secondary |
| 1041C0700X | Social Worker - Clinical | 3307 (Florida) | Primary |
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