=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982941845
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANCINE DEBORAH LASH LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/12/2013
-----------------------------------------------------
Last Update Date | 01/12/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4775 SW 164TH AVE
-----------------------------------------------------
City | MIRAMAR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33027-4697
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-243-8608
-----------------------------------------------------
Fax | 954-517-1596
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4775 SW 164TH AVE
-----------------------------------------------------
City | MIRAMAR
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33027-4697
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-243-8608
-----------------------------------------------------
Fax | 954-517-1596
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | SW 11148
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------