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General NPI Number Information
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NPI Number | 1053903732
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Entity Type | Organization
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Legal Business Name | MARIAM BESHARA LPC., PSYD
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Dates
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Enumeration Date | 02/04/2021
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Last Update Date | 11/03/2022
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Provider Practice Location Address
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Address Line | 2645 STARWOOD CIR
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City | WEST PALM BEACH
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State | FL
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Zip | 33406-5146
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Country | US
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Telephone | 561-406-4318
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Fax |
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Provider Business Mailing Address
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Address Line | 2645 STARWOOD CIR
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City | WEST PALM BCH
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State | FL
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Zip | 33406-5146
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Country | US
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Telephone | 561-386-7939
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIAM BESHARA
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Credential | LPC., PSYD
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Telephone | 561-386-7939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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