Provider Demographics
NPI:1255624151
Name:BATHELEMY, ANNEZE (MSW)
Entity type:Individual
Prefix:MRS
First Name:ANNEZE
Middle Name:
Last Name:BATHELEMY
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 1:8325 NE 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33138-3815
Mailing Address - Country:US
Mailing Address - Phone:786-267-1964
Mailing Address - Fax:786-664-6587
Practice Address - Street 1:8325 NE 2ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-3815
Practice Address - Country:US
Practice Address - Phone:786-267-1964
Practice Address - Fax:786-664-6587
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW33901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical