Provider Demographics
NPI:1326577644
Name:KIDDOE, KAARA DEFREITAS (MSW)
Entity Type:Individual
Prefix:MRS
First Name:KAARA
Middle Name:DEFREITAS
Last Name:KIDDOE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10736 SW 118TH PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-3955
Mailing Address - Country:US
Mailing Address - Phone:919-408-9319
Mailing Address - Fax:
Practice Address - Street 1:14401 OLD CUTLER RD
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33158-1722
Practice Address - Country:US
Practice Address - Phone:786-573-7010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW116241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical