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NPI Code Detail

MEDICARE: JESSICA MANTELL M.S., C.N.S., L.D.N

MEDICARE:   JESSICA  MANTELL  M.S., C.N.S., L.D.N
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1932745965
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MANTELL M.S., C.N.S., L.D.N
Provider Business Mailing Address
First Line : 1300 BRICKELL BAY DR APT 1204
Second Line :
City : MIAMI
State : FL
Zip : 33131-3385
Country : US
Telephone Number : 610-812-3543
Fax Number :
Provider Business Practice Location Address
First Line : 1300 BRICKELL BAY DR APT 1204
Second Line :
City : MIAMI
State : FL
Zip : 33131-3385
Country : US
Telephone Number : 610-812-3543
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/25/2019
Last Update Date : 11/25/2019

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Directions to “ JESSICA MANTELL M.S., C.N.S., L.D.N” Practice Location

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