MEDICARE: MS. TENNILLE GABRIEL VIOLANDI LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH20364	FL

General Provider Information

NPI Number	:	1710632831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TENNILLE GABRIEL VIOLANDI LMHC

Provider Business Mailing Address
First Line	:	4018 NW 70TH AVE
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-2242
Country	:	US
Telephone Number	:	954-592-3851
Fax Number	:

Provider Business Practice Location Address
First Line	:	4018 NW 70TH AVE
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-2242
Country	:	US
Telephone Number	:	954-592-3851
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2022
Last Update Date	:	02/22/2022

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