Healthcare Provider Details

I. General information

NPI: 1851113690
Provider Name (Legal Business Name): GUD KARMA COUNSELING & WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2024
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10400 GRIFFIN RD STE 105
DAVIE FL
33328-3320
US

IV. Provider business mailing address

9530 NW 8TH ST
PEMBROKE PINES FL
33024-6221
US

V. Phone/Fax

Practice location:
  • Phone: 954-837-0419
  • Fax:
Mailing address:
  • Phone: 954-837-0419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: GRISELL VAZQUEZ
Title or Position: OWNER
Credential: MS, LMHC
Phone: 954-837-0419