Healthcare Provider Details

I. General information

NPI: 1093915043
Provider Name (Legal Business Name): DIFFERENT LIKE ME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 11/07/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 W PALMETTO PARK RD STE 201
BOCA RATON FL
33433-3430
US

IV. Provider business mailing address

702 LUMPKIN ST
TRAVELERS REST SC
29690-1983
US

V. Phone/Fax

Practice location:
  • Phone: 561-270-2280
  • Fax: 561-270-2284
Mailing address:
  • Phone: 561-270-2280
  • Fax: 561-270-2284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW7605
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: ALYSE NOVEMBER
Title or Position: OWNER
Credential: PHD, LCSW
Phone: 561-270-2280