| None | |
|
2845 Sw 176th Ter Miramar FL 33029-5556 | |
| (954) 895-1465 | |
| (954) 433-3236 |
| Full Name | None |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2845 Sw 176th Ter, Miramar, Florida |
| Authorized Official Name and Position | Carol Choute Pierre (PRESIDENT) |
| Authorized Official Contact | 9548951465 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None 2845 Sw 176th Ter Miramar FL 33029-5556 Ph: (954) 895-1465 | None 2845 Sw 176th Ter Miramar FL 33029-5556 Ph: (954) 895-1465 |
| NPI Number | 1871744284 |
|---|---|
| Provider Enumeration Date | 10/03/2008 |
| Last Update Date | 10/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871744284 | NPI | - | NPPES |
| 308310100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 2679592 (Florida) | Primary |
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