License Number: SW8130

Data As Of 8/19/2022

Profession Licensed Clinical Social Worker
License SW8130
License Status CLEAR/ACTIVE
Qualifications Qualified Supervisor CSW
License Expiration Date 3/31/2023
License Original Issue Date 11/16/2005
Address of Record Partners Family Medicine
4453 Highway 90
PACE, FL 32571
Discipline on File No
Public Complaint No

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