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General NPI Number Information
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NPI Number | 1962529651
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Entity Type | Individual
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Provider Name | BRENDA STARR RN, LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3511 W COMMERCIAL BLVD #206
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City | FORT LAUDERDALE
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State | FL
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Zip | 33309
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Country | US
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Telephone | 954-629-4779
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Fax |
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Provider Business Mailing Address
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Address Line | 2232 N CYPRESS BEND DR APT 402
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City | POMPANO BEACH
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State | FL
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Zip | 33069-5602
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Country | US
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Telephone | 954-629-4779
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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 | SW 4284
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License Number State | FL
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