Healthcare Provider Details
I. General information
NPI: 1114591724
Provider Name (Legal Business Name): NAYELIE JEAN LOUIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/18/2021
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2330 S CONGRESS AVE
WEST PALM BEACH FL
33406-7608
US
IV. Provider business mailing address
2330 S CONGRESS AVE
WEST PALM BEACH FL
33406-7608
US
V. Phone/Fax
- Phone: 561-432-5849
- Fax: 561-899-4867
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | SW23891 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: