Most Relevant Information
Provider Data
| NPI Number: | 1003581281 |
| Provider Name: | CARLY PASS LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | SW16878 |
Most Important Dates
| Enumeration Date: | 08/10/2021 |
| Last Updated: | 08/10/2021 |
Provider Practice Location
25250 DIVOT DR
BONITA SPRINGS
FL
341356755
Practice Location Phone/Fax
| Phone: | 2392870199 |
| Fax: |
Provider Mailing Location
25250 DIVOT DR
BONITA SPRINGS
FL
341356755
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |