Provider Demographics
NPI:1851499842
Name:ALBERTS, ARDELLA
Entity Type:Individual
Prefix:MRS
First Name:ARDELLA
Middle Name:
Last Name:ALBERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2842 SW DINNER ST
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-3215
Mailing Address - Country:US
Mailing Address - Phone:772-873-9388
Mailing Address - Fax:772-873-9388
Practice Address - Street 1:2842 SW DINNER ST
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-3215
Practice Address - Country:US
Practice Address - Phone:772-873-9388
Practice Address - Fax:772-873-9388
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker