Provider Demographics
NPI:1104485515
Name:DAMIER, CARA ANGEL
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:ANGEL
Last Name:DAMIER
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 1:730 PLACE CHATEAU
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-2213
Mailing Address - Country:US
Mailing Address - Phone:561-398-6712
Mailing Address - Fax:
Practice Address - Street 1:200 KNUTH RD STE 254
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-4637
Practice Address - Country:US
Practice Address - Phone:561-220-1973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH16110101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health