| Sandra S Champa Lcsw Cap Llc | |
|
5700 Lake Worth Rd Suite 209-5 Greenacres FL 33463-4727 | |
| (561) 929-3792 | |
| (561) 265-1349 |
| Full Name | Sandra S Champa Lcsw Cap Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5700 Lake Worth Rd, Greenacres, Florida |
| Authorized Official Name and Position | Sandra S Champa (OWNER) |
| Authorized Official Contact | 5619293792 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandra S Champa Lcsw Cap Llc 5700 Lake Worth Rd Suite 209-5 Greenacres FL 33463-4727 Ph: (561) 929-3792 | Sandra S Champa Lcsw Cap Llc 5700 Lake Worth Rd Suite 209-5 Greenacres FL 33463-4727 Ph: (561) 929-3792 |
| NPI Number | 1750760526 |
|---|---|
| Provider Enumeration Date | 05/26/2015 |
| Last Update Date | 05/26/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750760526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | L15000068881 (Florida) | Primary |
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