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General NPI Number Information
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NPI Number | 1033620125
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Entity Type | Individual
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Provider Name | RACHEL KONNERTH
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Gender | Female
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Dates
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Enumeration Date | 10/17/2017
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Last Update Date | 10/17/2017
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Provider Practice Location Address
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Address Line | 2045 N UNIVERSITY DR
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City | SUNRISE
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State | FL
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Zip | 33322-3936
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Country | US
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Telephone | 954-947-9732
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Fax |
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Provider Business Mailing Address
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Address Line | 9050 JACARANDA LN APT 1
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City | PLANTATION
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State | FL
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Zip | 33324-3609
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH13911
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License Number State | FL
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