Provider Information for 1194311175
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EVE MARY CARMELLE ELLEN RICHARD LCSW
Sex: Female
NPI: 1194311175
Last Updated: 2020-12-14
Certification Date: 2020-12-14
Certification Date: 2020-12-14
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1194311175 | ||||||||
| Enumeration Date | 2020-12-14 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 951 SW 146TH TER PEMBROKE PINES, FL 33027-6137 United States Phone: 800-274-7603 | Fax: | ||||||||
| Primary Practice Address | 951 SW 146TH TER PEMBROKE PINES, FL 33027-6137 United States Phone: 800-274-7603 | Fax: | ||||||||
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