Healthcare Provider Details

I. General information

NPI: 1982305504
Provider Name (Legal Business Name): MRS. LEAH RAC-MAAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2023
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2313 N CONGRESS AVE APT 34
BOYNTON BEACH FL
33426-8608
US

IV. Provider business mailing address

2313 N CONGRESS AVE APT 34
BOYNTON BEACH FL
33426-8608
US

V. Phone/Fax

Practice location:
  • Phone: 561-713-9612
  • Fax:
Mailing address:
  • Phone: 561-713-9612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number26223
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: