Healthcare Provider Details

I. General information

NPI: 1669824686
Provider Name (Legal Business Name): WAYS 4 WOMEN CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2016
Last Update Date: 07/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3561 NW 9TH AVE
OAKLAND PARK FL
33309-5928
US

IV. Provider business mailing address

3561 NW 9TH AVE
OAKLAND PARK FL
33309-5928
US

V. Phone/Fax

Practice location:
  • Phone: 954-579-9935
  • Fax:
Mailing address:
  • Phone: 954-579-9935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number2016001522
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number2016001522
License Number StateFL

VIII. Authorized Official

Name: EDWIN MAUGHN
Title or Position: OWNER
Credential: MS
Phone: 954-579-9935