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General NPI Number Information
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NPI Number | 1093996910
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Entity Type | Individual
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Provider Name | GAIL SANDRA STARR LCSW CDE
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Gender | Female
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 11/20/2007
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Provider Practice Location Address
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Address Line | 3450 NORTHLAKE BLVD SUITE 212 IN CARE OF ERE ASSOCIATES
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33403-1712
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Country | US
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Telephone | 561-626-8070
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Fax | 561-626-2828
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Provider Business Mailing Address
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Address Line | 7325 SW 63RD AVE SUITE 101 IN CARE OF ERE ASSOCIATES
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4812
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Country | US
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Telephone | 305-284-1143
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Fax | 305-667-9880
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW5596
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 20020544
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License Number State | FL
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