Healthcare Provider Details

I. General information

NPI: 1164801916
Provider Name (Legal Business Name): ANTONIA GEORGE LMFT, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2015
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11854 DUNBAR CT
PALM BEACH GARDENS FL
33412-1620
US

IV. Provider business mailing address

11854 DUNBAR CT
PALM BEACH GARDENS FL
33412-1620
US

V. Phone/Fax

Practice location:
  • Phone: 516-382-5440
  • Fax:
Mailing address:
  • Phone: 516-382-5440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: