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General NPI Number Information
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NPI Number | 1235452947
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Entity Type | Individual
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Provider Name | MICHELE GRECO MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 600 N HIGHWAY 17/92 SUITE 168A
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City | LONGWOOD
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State | FL
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Zip | 32750-3624
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Country | US
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Telephone | 407-619-6620
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 52
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City | SANFORD
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State | FL
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Zip | 32772-0052
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Country | US
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Telephone | 407-273-8570
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Fax |
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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 | SW7047
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License Number State | FL
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