Healthcare Provider Details

I. General information

NPI: 1821771239
Provider Name (Legal Business Name): MS. ELIZABETH SANDERS WOHLFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2023
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 BOND WAY
DELRAY BEACH FL
33483-5824
US

IV. Provider business mailing address

801 BOND WAY
DELRAY BEACH FL
33483-5824
US

V. Phone/Fax

Practice location:
  • Phone: 561-396-0606
  • Fax:
Mailing address:
  • Phone: 561-396-0606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH17771
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: