Provider Demographics
NPI:1700259652
Name:MIRABAL, DAGMAR MAE (LCSW)
Entity Type:Individual
Prefix:
First Name:DAGMAR
Middle Name:MAE
Last Name:MIRABAL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8516 CUTLER CT
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-2511
Mailing Address - Country:US
Mailing Address - Phone:305-331-2239
Mailing Address - Fax:305-489-7837
Practice Address - Street 1:8516 CUTLER CT
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-2511
Practice Address - Country:US
Practice Address - Phone:305-331-2239
Practice Address - Fax:305-489-7837
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-01
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW132601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical