MEDICARE: MS. ZERESH AMBER ALTORK M. ED., CD, CCE

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	374J00000X	Doula
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1871819805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ZERESH AMBER ALTORK M. ED., CD, CCE

Provider Business Mailing Address
First Line	:	2663 SE 28TH CIR
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33435-8969
Country	:	US
Telephone Number	:	561-808-3142
Fax Number	:

Provider Business Practice Location Address
First Line	:	2112 S CONGRESS AVE STE 104
Second Line	:
City	:	PALM SPRINGS
State	:	FL
Zip	:	33406-7670
Country	:	US
Telephone Number	:	561-653-6292
Fax Number	:

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

Provider Enumeration Date	:	04/15/2010
Last Update Date	:	10/29/2015

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