| Collective Self Llc | |
|
4400 W Sample Rd Ste 112 Coconut Creek FL 33073-3457 | |
| (954) 240-0884 | |
| (505) 438-1820 |
| Full Name | Collective Self Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 4400 W Sample Rd Ste 112, Coconut Creek, Florida |
| Authorized Official Name and Position | Gwenevere Abriel (CEO) |
| Authorized Official Contact | 9542400884 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Collective Self Llc 5379 Lyons Rd # 172 Coconut Creek FL 33073-2810 Ph: () - | Collective Self Llc 4400 W Sample Rd Ste 112 Coconut Creek FL 33073-3457 Ph: (954) 240-0884 |
| NPI Number | 1821864505 |
|---|---|
| Provider Enumeration Date | 12/04/2023 |
| Last Update Date | 12/04/2023 |
| Certification Date | 12/03/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821864505 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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