Healthcare Provider Details

I. General information

NPI: 1356893408
Provider Name (Legal Business Name): ASHAKI SYPHER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 10/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 BLUE HERON BLVD W
RIVIERA BEACH FL
33404-5003
US

IV. Provider business mailing address

1528 PARKWAY CT
GREENACRES FL
33413-3078
US

V. Phone/Fax

Practice location:
  • Phone: 561-841-3500
  • Fax:
Mailing address:
  • Phone: 561-803-5822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: