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General NPI Number Information
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NPI Number | 1063838951
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Entity Type | Organization
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Legal Business Name | STEPHANIE COBERLY, LMHC PA
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Dates
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Enumeration Date | 03/15/2014
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Last Update Date | 03/15/2014
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Provider Practice Location Address
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Address Line | 9050 PINES BLVD STE 383
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6400
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Country | US
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Telephone | 954-324-8383
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Fax | 954-324-8383
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Provider Business Mailing Address
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Address Line | 9050 PINES BLVD STE 383
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6400
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Country | US
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Telephone | 954-324-8383
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Fax | 954-324-8383
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Authorized Official
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Title or Position | VP
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Name | MR. RICHARD LEE COBERLY
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Credential |
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Telephone | 954-324-8383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | MH9399
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License Number State | FL
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