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General NPI Number Information
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NPI Number | 1275268211
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Entity Type | Individual
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Provider Name | GRACE CHO RCSWI
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Gender | Female
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Dates
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Enumeration Date | 07/22/2022
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 6201 SW180TH TERRACE
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City | SOUTHWEST RANCHES
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State | FL
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Zip | 33331
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Country | US
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Telephone | 954-547-9928
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Fax | 754-400-9113
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Provider Business Mailing Address
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Address Line | 3901 SHADY RIDGE RD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-6205
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Country | US
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Telephone | 954-547-9928
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Fax | 754-400-9113
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 16484
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License Number State | FL
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